Other Titles
Rural Clinic Nurse Practitioner and Staff Perspectives on a Chlamydia Screening Improvement Project [Title Slide]
Other Titles
PechaKucha Presentation
Abstract
Regular Chlamydia trachomatis (CT) screening is imperative for sexually active young women in rural areas, where CT is increasingly prevalent1,2. Females age15-24 are at highest risk among all populations of acquiring CT3. Symptoms of CT are absent or subtle, often delaying detection and treatment. Without treatment, CT may lead to pelvic inflammatory disease (PID), increasing the risk of infertility and life-threatening tubal pregnancy4. Chlamydia screening is a high impact service5 that reduces the incidence of PID by up to 60%6. Screening resources mitigate a “double disparity”7 of low healthcare access combined with poorer overall health in rural areas; however, those resources are diminishing1. As nurse practitioners (NPs) represent over 25% of rural healthcare providers8, they play pivotal roles in early CT detection and treatment.
The purposes of this project are to: (1) improve CT screening in two NP-led rural clinics; and (2) explore NP and staff perspectives about the improvement (QI) efforts. The first aim is to close the gap between the clinics’ 2023 CT screening rate among eligible female patients and a National Committee for Quality Assurance benchmark. The clinic’s target metric for 2024 is ≥61.47%. By achieving this metric, the clinics become eligible for financial incentives from the California Quality Incentive Pool program. The second aim is to derive insights from NP and staff perspectives about the project that may inform CT screening improvements in rural areas.
A graduate NP student and an NP academic advisor facilitated the project. In six monthly virtual meetings, clinic NPs and staff learned optimal CT screening practices, used a “plan-do-study-act” approach to their QI efforts, and monitored metrics. Interim data show the target is currently surpassed at 64.87%. Final metrics, as well as the results of a mixed-methods survey exploring NP and clinic staff perspectives, will be available in April 2025.
Chlamydia screening QI efforts should target rural areas to mitigate health disparities and increasing CT prevalence. This study’s preliminary findings confirm that rural clinic efforts at meeting national CT screening benchmarks are impactful5. The increasing prominence of NPs in rural healthcare obliges them to support and lead CT detection and treatment efforts, as well as other rural health QI efforts.
Notes
References: 1. Jenkins, W. D., Williams, L. D., & Pearson, W. (2021). Sexually transmitted infection epidemiology and care in rural areas: A narrative review. Sexually Transmitted Diseases, 48(12), e236–e240. https://doi.org/10.1097/OLQ.0000000000001512
2. Giannouchos, T. V., Crouch, E., Merrell, M., Brown, M. J., Harrison, S. E., & Pearson, W. S. (2022). Racial, ethnic, and rural/urban disparities in HIV and sexually transmitted infections in South Carolina, Journal of Community Health, 48(1), 152–159. https://doi.org/10.1007/s10900-022-01165-6
3. Centers for Disease Control and Prevention (2024, January30). Chlamydia – Rates of reported cases by age group and sex, United States, 2022. https://www.cdc.gov/std/statistics/2022/figures/ct-2.htm. U.S. Department of Health & Human Services.
4. Alexiou, Z. W., Hoenderboom, B. M., Hoebe, C. J. P. A., Dukers-Muijrers, N. H. T. M., Götz, H. M., van der Sande, M. A. B., deVries, H. J. C., den Hartog, J. E., Morré, S. A., & van Benthem, B. H. B. (2024). Reproductive tract complication risks following Chlamydia trachomatis infections: A long-term prospective cohort study from 2008-2022. The Lancet Regional Health – Europe, 45. Article 101027. https://doi.org/10.1016/j.lanepe.2024.101027
5. Shields-Haas, V., & Bray, C. (2023). Improving effective chlamydia screening for women at risk at a rural family planning clinic. Journal of Doctoral Nursing Practice, 16(3), 205–212. https://doi.org/10.1891/JDNP-2023-0010
6. National Chlamydia Coalition. (2021). Why screen for chlamydia? An implementation guide for healthcare providers. http://chlamydiacoalition.org/for-healthcare-providers/why-screen-for-chlamydia/. American Sexual Health Association.
7. Valentine, J. A., Delgado, L. F., Haderxhanaj, L. T., & Hogben, M. (2022). Improving sexual health in U.S. rural communities: Reducing the impact of stigma. AIDS and Behavior, 26(Suppl 1), 90–99. https://doi.org/10.1007/s10461-021-03416-4f
8. American Association of Nurse Practitioners. (2024, January 3). AANP spotlights five critical health care trends to watch. https://www.aanp.org/news-feed/aanp-spotlights-five-critical-health-care-trends-to-watch. American Association of Nursing Practitioners.
Sigma Membership
Iota Iota
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Equity, Social Determinants of Health, Pubic and Community Health, Primary Care, Chlamydia Screening, Rural Areas
Recommended Citation
Cummins, Denise; Jorgensen, Lydia; and Watson, Adrianna Lorraine, "Improving Chlamydia Screening in Rural Clinics - Nurse Practitioner and Staff Perspectives" (2025). International Nursing Research Congress (INRC). 39.
https://www.sigmarepository.org/inrc/2025/presentations_2025/39
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Improving Chlamydia Screening in Rural Clinics - Nurse Practitioner and Staff Perspectives
Seattle, Washington, USA
Regular Chlamydia trachomatis (CT) screening is imperative for sexually active young women in rural areas, where CT is increasingly prevalent1,2. Females age15-24 are at highest risk among all populations of acquiring CT3. Symptoms of CT are absent or subtle, often delaying detection and treatment. Without treatment, CT may lead to pelvic inflammatory disease (PID), increasing the risk of infertility and life-threatening tubal pregnancy4. Chlamydia screening is a high impact service5 that reduces the incidence of PID by up to 60%6. Screening resources mitigate a “double disparity”7 of low healthcare access combined with poorer overall health in rural areas; however, those resources are diminishing1. As nurse practitioners (NPs) represent over 25% of rural healthcare providers8, they play pivotal roles in early CT detection and treatment.
The purposes of this project are to: (1) improve CT screening in two NP-led rural clinics; and (2) explore NP and staff perspectives about the improvement (QI) efforts. The first aim is to close the gap between the clinics’ 2023 CT screening rate among eligible female patients and a National Committee for Quality Assurance benchmark. The clinic’s target metric for 2024 is ≥61.47%. By achieving this metric, the clinics become eligible for financial incentives from the California Quality Incentive Pool program. The second aim is to derive insights from NP and staff perspectives about the project that may inform CT screening improvements in rural areas.
A graduate NP student and an NP academic advisor facilitated the project. In six monthly virtual meetings, clinic NPs and staff learned optimal CT screening practices, used a “plan-do-study-act” approach to their QI efforts, and monitored metrics. Interim data show the target is currently surpassed at 64.87%. Final metrics, as well as the results of a mixed-methods survey exploring NP and clinic staff perspectives, will be available in April 2025.
Chlamydia screening QI efforts should target rural areas to mitigate health disparities and increasing CT prevalence. This study’s preliminary findings confirm that rural clinic efforts at meeting national CT screening benchmarks are impactful5. The increasing prominence of NPs in rural healthcare obliges them to support and lead CT detection and treatment efforts, as well as other rural health QI efforts.
Description
Regular Chlamydia trachomatis (CT) screening is imperative for sexually active young women in rural areas, where CT is increasing and screening resources are diminishing. The purposes of this project are to improve CT screening in two rural health clinics and explore the perspectives of the clinics' NPs and staff on the efforts. Preliminary screening data shows improvement. The increasing prominence of NPs in rural healthcare obliges them to support and lead CT detection and treatment efforts.