Education on Opt-Out Screening of Chlamydia and Gonorrhea: Increasing Provider Buy-In

Abstract

Purpose. This quality improvement (QI) project aimed to increase staff awareness at this clinic about STI screening data, risk of bias, and the opt-out screening method to increase STI screening rates, specifically for chlamydia and gonorrhea, in sexually active females ages 24 and younger. Background. In the United States, chlamydia and gonorrhea are among the most prevalent sexually transmitted infections (STIs), with about half of all new reported STIs among those ages 15 to 24. Most women infected with chlamydia or gonorrhea remain asymptomatic. Therefore, guidelines published by the Centers for Disease Control (CDC), United States Preventative Service Task Force (USPSTF), and American College of Gynecologists and Obstetricians (ACOG) recommend screening for all sexually active women ages 24 and younger, including those that are asymptomatic, to control the transmission of the disease and infection-related complications, including pelvic inflammatory disease. Methods: Nurse practitioners and nurse practitioner students at Patel HealthCare were eligible for participation in this QI project. A total of two individuals participated in this QI project by completing a pre- and post-questionnaire regarding the educational video of opt-out screening to increase STI detection rates. After the intervention, the project coordinator compared pre/post responses to evaluate increases in health literacy regarding STIs and willingness to implement opt-out screening. Results. Two out of twelve eligible participants completed the QI project in entirety. The average knowledge self-assessment score on the pre-questionnaire was 50%, and the average score on the post-questionnaire was 80%. Likert-scale responses indicated increased confidence in the benefits of opt-out screening, increased confidence in the guidelines for chlamydia and gonorrhea screening in this population, and increased confidence in the ability to provide sexual health education Conclusion. Implementing opt-out screening in primary care can standardize and increase screening rates. This QI project raised awareness about the STI epidemic and opt-out screening, with participants reporting greater confidence and knowledge following the QI intervention. Future projects could focus on real-world implementation and patient feedback.