Weber Garrett, Chappelle Emmett, Bares Valerie J
University of South Dakota Sanford School of Medicine.
Sanford Research, COMMAND Core, Sioux Falls, South Dakota.
S D Med. 2020 Jan;73(1):17-20.
Hepatitis C is a bloodborne viral infection that often leads to liver disease. Individuals born between 1945-1965 (baby boomer birth cohort) are five times more likely to have hepatitis C than other age groups due to blood transfusions and medical procedures performed before the discovery of the virus. The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend a one-time screening for individuals in the baby boomer birth cohort. Even with these recommendations, national screening rates remain low at around 13 percent, suggesting a need for improvement. In this study we reviewed the electronic medical record (EMR) data for a rural primary care clinic and determined the percentage of individuals screened in the baby boomer birth cohort in a one-year time period. Interventions (provider/nursing education, community education) were implemented over a four-month period. We compared the EMR data from before, during, and after interventions. Pearson's chi-squared analysis was used to evaluate differences in proportions. The results showed no statistical significance between the three timeframes measured (p-value 0.6164). We can conclude that the interventions used in this study were not adequate in producing a statistically significant change in the percentage of baby boomers screened at our local clinic. These results could be due to interventions not being implemented simultaneously, lack of follow-up with staff regarding interventions, and a short time frame for measuring post-intervention changes. Future projects may benefit from modifying interventions and their implementation.
丙型肝炎是一种通过血液传播的病毒感染，常导致肝脏疾病。由于在病毒被发现之前接受过输血和医疗程序，1945年至1965年出生的人群（婴儿潮一代出生队列）感染丙型肝炎的可能性是其他年龄组的五倍。疾病控制与预防中心以及美国预防服务工作组建议对婴儿潮一代出生队列中的个体进行一次性筛查。即便有这些建议，全国筛查率仍很低，约为13%，这表明有改进的必要。在本研究中，我们回顾了一家农村初级保健诊所的电子病历（EMR）数据，并确定了在一年时间内婴儿潮一代出生队列中接受筛查的个体百分比。在四个月的时间里实施了干预措施（提供者/护理教育、社区教育）。我们比较了干预前、干预期间和干预后的EMR数据。使用Pearson卡方分析来评估比例差异。结果显示，在所测量的三个时间框架之间没有统计学意义（p值为0.6164）。我们可以得出结论，本研究中使用的干预措施不足以在我们当地诊所筛查的婴儿潮一代百分比上产生统计学上的显著变化。这些结果可能是由于干预措施没有同时实施、缺乏对工作人员干预措施的跟进以及测量干预后变化的时间框架较短。未来的项目可能会从修改干预措施及其实施方式中受益。
