Nelson Jennifer M, Woolever Nathan, Meyer Lisa, Hall Scott, Stakston Jaclyn, Dababneh Ala, Roush Kathleen, Van Sistine Michael, Tempelis Jennifer, Dierkhising Ross A, Lessard Sarah
From the Department of Pharmacy Services, Mayo Clinic Health System, La Crosse, WI.
Department of Infectious Disease, Mayo Clinic, Rochester, MN.
Sex Transm Dis. 2023 Mar 1;50(3):167-171. doi: 10.1097/OLQ.0000000000001745. Epub 2022 Dec 1.
Sexual assault survivors are at increased risk for sexually transmitted infections. Sexual Assault Nurse Examiner programs guide sexually transmitted infection treatment, monitoring, and follow-up scheduling according to guidelines by the Centers for Disease Control and Prevention (CDC). Reported low rates of provider adherence to CDC treatment guidelines and patient adherence to follow-up necessitate a review of medication prescribing and follow-up scheduling practices, especially at smaller community hospitals in the United States.
A retrospective medical record review was conducted to assess adherence rates to CDC guidelines for prescribing practices, scheduling, and follow-up of sexual assault survivors. We included pediatric and adult patients presenting to the emergency department (ED) and participating in the ED Sexual Assault Nurse Examiner program at a rural, community-based teaching hospital in La Crosse, WI, from January 2018 to December 2021. Descriptive statistics were used to evaluate results.
Analysis included 103 patients. Prescribing adherence to CDC guidelines was >80% for all except human immunodeficiency virus (53.4%), trichomoniasis (68.1%), and hepatitis B (69%). Of the 38 patients who had a follow-up scheduled during their ED encounter, 78.9% attended their scheduled follow-up and 94.7% of those appointments were scheduled within the CDC-recommended time frame, leading to an overall adherence of 40%.
Adherence rates were high for most prescribing practices, and attendance of scheduled follow-up was higher than expected. Opportunities to improved adherence to CDC guidelines were identified in prescribing for 3 disease states (human immunodeficiency virus, trichomoniasis, and hepatitis B) and in scheduling of follow-up.
性侵犯幸存者感染性传播感染的风险增加。性侵犯护士检查项目根据美国疾病控制与预防中心（CDC）的指南指导性传播感染的治疗、监测和后续随访安排。据报道，医疗服务提供者对CDC治疗指南的依从率较低，患者对后续随访的依从性也较低，因此有必要审查药物处方和随访安排做法，尤其是在美国较小的社区医院。
进行了一项回顾性病历审查，以评估对CDC关于性侵犯幸存者处方做法、随访安排和后续随访指南的依从率。我们纳入了2018年1月至2021年12月期间在威斯康星州拉克罗斯市一家农村社区教学医院急诊科就诊并参与急诊科性侵犯护士检查项目的儿科和成年患者。采用描述性统计来评估结果。
分析包括103名患者。除人类免疫缺陷病毒（53.4%）、滴虫病（68.1%）和乙型肝炎（69%）外，所有其他疾病的处方依从CDC指南的比例均>80%。在急诊科就诊期间安排了后续随访的38名患者中，78.9%的患者参加了预定的随访，其中94.7%的预约是在CDC推荐的时间范围内安排的，总体依从率为40%。
大多数处方做法的依从率较高，预定随访的出勤率高于预期。在3种疾病状态（人类免疫缺陷病毒、滴虫病和乙型肝炎）的处方以及随访安排方面发现了提高对CDC指南依从性的机会。
