Foppert Leigh, Bowles Wendy, Belardo Haley, Zeno Rosie, Hosley Stephanie, Wood Sarah
Center for Healthcare Quality and Analytics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Ohio State University, Columbus, Ohio, USA.
J Adv Nurs. 2024 Nov 4. doi: 10.1111/jan.16595.
To increase Chlamydia trachomatis screening in adolescents 15-19 years of age from 7.8% to 15% following a 6-week implementation of universal chlamydia screening at three paediatric primary care (PPC) sites.
Pre-implementation (1 January 2022-19 October 2022) and post-implementation (20 October 2022-1 June 2023) screening rates were tracked through run charts and compared via Chi-square testing. Universal opt-out chlamydia screening with universal urine collection for 15- to 19-year-old was implemented at well visits, along with patient and staff education, and sexually transmitted infection treatment protocols.
Chlamydia trachomatis screening increased from 7.8% to 34.1% with implementation of universal opt-out chlamydia screening. Proportions of patients screened increased significantly among White individuals, males and privately insured individuals.
A universal C. trachomatis screening project can be feasibly implemented in pediatric primary care and successfully increase adolescent chlamydia screening rates.
Implementing a universal opt-out C. trachomatis screening project is feasible in PPC and can help achieve the public health goal of chlamydia identification and treatment.
These findings will be impactful for both paediatric primary care and adolescent patients. The universal, opt-out C. trachomatis screening approach facilitated screening increases, improved equity in screening and led to increased case detection and treatment which has vast significance for those patients.
This manuscript is submitted using the SQUIRE 2.0 guidelines for quality improvement reporting.
Patient contribution included de-identified data collection of chlamydia screening rates of eligible adolescents 15-19 years old who attended routine well visits at the three PPC locations. The data were reviewed on a dashboard, then stratified by race, ethnicity, payor and sex assigned at birth.
在三个儿科初级保健（PPC）机构实施为期6周的普遍沙眼衣原体筛查后，将15至19岁青少年的沙眼衣原体筛查率从7.8%提高到15%。
通过运行图跟踪实施前（2022年1月1日至2022年10月19日）和实施后（2022年10月20日至2023年6月1日）的筛查率，并通过卡方检验进行比较。在健康检查时对15至19岁青少年实施普遍的选择退出式沙眼衣原体筛查及普遍尿液采集，同时开展患者和工作人员教育以及性传播感染治疗方案。
实施普遍的选择退出式沙眼衣原体筛查后，沙眼衣原体筛查率从7.8%提高到了34.1%。在白人、男性和私人保险参保者中，接受筛查的患者比例显著增加。
普遍的沙眼衣原体筛查项目可在儿科初级保健中切实可行地实施，并成功提高青少年沙眼衣原体筛查率。
在儿科初级保健中实施普遍的选择退出式沙眼衣原体筛查项目是可行的，有助于实现沙眼衣原体识别和治疗的公共卫生目标。
这些发现对儿科初级保健和青少年患者都将产生影响。普遍的选择退出式沙眼衣原体筛查方法促进了筛查率的提高，改善了筛查的公平性，并导致病例发现和治疗增加，这对这些患者具有重大意义。
本手稿按照SQUIRE 2.0质量改进报告指南提交。
患者贡献包括对在三个PPC地点参加常规健康检查的15至19岁符合条件青少年的沙眼衣原体筛查率进行去识别化数据收集。数据在仪表板上进行审查，然后按种族、族裔、付款人以及出生时指定的性别进行分层。
