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Dispatching Nurses to Test for STIs Exponentially Increased Screening Rates at a New York Clinic

Rates of sexually transmitted infections (STIs) continue to rise across the United States and the world, perhaps as a result of decreased condom use in the undetectable = untransmittable era. In an effort to up the number of STIs diagnosed and treated, the screening rates must also be increased. Dispatching nurses to aid in testing could help achieve that goal.

A recent program developed and implemented at New York Presbyterian Hospital’s Center for Special Studies (CSS) clinic demonstrates that creating policies allowing nurses to test patients for rectal and pharyngeal gonorrhea/chlamydia increased the number of screenings 511% from 2015 (prior to implementation) to 2018. A poster detailing the findings was presented at the Association of Nurses in AIDS Care Conference (ANAC 2019).

Historically at CSS, only physicians performed rectal and pharyngeal gonorrhea/chlamydia testing, which tethered patient screening to physician availability. To combat this issue, Andrew Yu, RN, of New York Presbyterian, created 2 nursing policies. The first expanded the specimen collection policy to include rectal and pharyngeal screening for registered nurses (RNs) to perform the test, as well as an option for patients to self-collect. The second allowed RNs to use a non-patient specific standing order for STI screening, as long as patients did not need treatment, under the authorization of the medical director as well as the New York Nurse Practice Act.

The number of STI screenings increased exponentially from 369 rectal and pharyngeal swabs performed in 2015 prior to policy implementation to 865 swabs in 2016, 1474 swabs in 2017, and 1889 swabs in 2018—a 511% increase from screening implementation.

“The STI screening policy for nursing was expanded from CSS to the rest of the hospital, including other ambulatory care clinics as well as the Emergency Room,” Yu reported. “Based on the standing order created for STI screening, another opportunity for an RN screening standing order was developed for PPD screening.”

The poster, “Multi-Site Sexually Transmitted Infection (STI) Screening: Increasing Access to Care,” was presented Thursday, November 7, 2019, at the Association of Nurses in AIDS Care Conference (ANAC 2019) in Portland, Oregon.
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