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theses

Purpose of the Project: Screening for hepatitis C virus (HCV) is the first step in preventing HCV transmission and treating the disease. Despite multiple access points to health care, the emergency department (ED) is a crucial arena for delivering urgent care services and often serves as the front door to the hospital. As such, ED nurses are in a prime position to screen for HCV infection in adults. The aim of this project is to improve the HCV screening rate among patients 18 years and older in the Emergency department.
Methodology: The purpose of this project was to improve HCV screening rates over baseline among patients seen in the ED. This project aimed to increase HCV screening by 10%. The project used retrospective and prospective chart reviews to assess the intervention’s effects. The DNP student selected 200 random charts from the ED’s electronic medical records (EMRs) during the two months immediately preceding and following the intervention. Eligible charts of patients included those for patients 18 years of age and older of any gender. Charts of patients who had a pre-existing HCV diagnosis were excluded. Each review evaluated the number and percentage of charts with documentation of HCV screening and the rates of acceptance/refusal of screening.
Results: The DNP student reviewed a total of 200 patient charts (n=200) (i.e., 200 records each pre-and post-implementation). The chi-square test of association between pre-and post-implementation was statistically significant (chi-square1df = 183.65, p < 0.0001). This confirms that HCV test offerings increased significantly following the project’s educational intervention.
Implication for Practice: HCV infections are on the rise. It is imperative to implement new approaches to improve screening rates because the more patients are screened, the more patients are diagnosed and treated. Without implementing a process flow to address this gap related to HCV testing, EDs may continue to miss opportunities to identify undiagnosed HCV infection and facilitate linkage to treatment. The most common facilitator of HCV screening was structured educational initiatives among nurses. This project described an effort to implement evidence-based practices by creating and integrating HCV screening into the ED workflow, starting at, and implementing a PDSA framework cycle to improve HCV screening rates.

http://dissertations.umi.com/RBHS:10165

D.N.P.

Includes bibliographical references

doi:10.7282/t3-h2bj-fq19

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