Doctoral Project Defense: Kate Sandusky
Candidate: Kate Sandusky
Major: Nursing Practice
Advisor: Kelly Thompson-Brazill, D.N.P.
Title: The Impact of an Educational Intervention on Emergency Department Advance Practice Providers’ Sexually Transmitted Infection Treatment Guideline Adherence
Despite continually evolving guidelines for the treatment of sexually transmitted infections (STI), specifically chlamydia, gonorrhea, and syphilis, they remain some of the most common bacterial infections within the United States.
This project evaluated if an educational presentation reviewing three specific areas of the 2021 Centers for Disease Control and Prevention (CDC) sexually transmitted infection treatment guidelines: medication management, the 5Ps, and community follow-up, will change provider treatment adherence for individuals seeking care for possible STI exposure/symptoms.
A retrospective and prospective chart review following an educational presentation evaluating the nurse practitioner (NP) and physician assistance (PA) treatment adherence for individuals seeking care for STI exposure/symptoms by advanced practice providers in two EDs in southern Arizona based on the 2021 CDC guidelines.
This project included a chart review of individuals receiving care between March 1, 2022, and August 31, 2022. Each chart was identified by a specific IDC 10 Code, received care from an NP or PA who received the educational intervention, and was 18 years of age or older.
Seventy-nine charts were reviewed based on inclusion criteria during the six-month project period. Patient-specific demographics indicated that more individuals were documented to have a primary care provider (PCP), 15% versus 2.6%. There was no statistical change in medication treatment adherence between pre-and post-intervention phases, with the majority of inappropriate medication management being associated with patient refusal of treatment. The post-intervention phase indicated a decrease in testing for syphilis/HIV compared to preintervention, 35% versus 66.7%. There was no improvement in overall documentation of the 5Ps during the project, and there continued to be a high percentage, 42.5%, during the postintervention phase for follow-up at the primary care provider’s office, even as the majority of charts did not have an identified primary care provider.
This project highlights that an educational intervention alone does not improve treatment guideline adherence and that further investigation must be completed to identify other areas of support to improve adherence to the 2021 CDC sexually transmitted infection treatment guideline.