Implementation of a Syphilis Screening Tool in a Primary Care Clinic

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Elliott, Susan

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Health screenings are important for health promotion and the prevention of disease. Screening for STIs can be conducted in diverse healthcare settings, yet it has been found that patients often seek screening from sexually transmitted infection (STI) clinics more often than from primary care providers (Hoover et al., 2015). Primary care providers are in an optimal position to screen patients for syphilis. Syphilis infection is a sexually transmitted infection (STI) for which individuals can be screened. The purpose of this project was to create a syphilis screening tool for primary care providers to use with sexually active adult patients and to implement the tool in one primary care clinic. Inclusion criteria were non-pregnant adults, 18 years of age or older. The screening tool was used to screen patients for high-risk sex practices. Patients determined by the screening to be in a high-risk category; they were then educated about the STI and offered testing. This quality improvement project aimed to increase appropriate syphilis screening in a primary care clinic in eastern North Carolina over a 9-week implementation phase. The project was guided by Lewin’s Change Theory to assist participants with adaptation to a standardized process for patient screening at the project site. The screening tool was used in 6% of appropriate patient encounters. During the implementation phase, only 0.27% of the appropriate patients had documented billing codes for syphilis testing.