Date of Award

Spring 5-27-2017

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Jonathan Mack, PhD, RN, APN-BC

Abstract

Introduction

Chlamydia and gonorrhea continue to be a detriment to public health, particularly those under the age of 25. These sexually transmitted infections can cause long-term health problems and should not be viewed lightly. Specifically, untreated or recurrent Chlamydia is the number one cause of ectopic pregnancy, tubal infertility, and pelvic inflammatory disease. Urinary tract complaints are a prime opportunity for concurrent testing since many patients with dysuria may actually have a sexually transmitted infection causing urethritis. Traditional testing can be difficult and invasive because it requires either a pelvic exam or a repeat dirty urine sample spaced at least one hour from clean-catch urinalysis.

Methods

Female patients between the ages of 14-25 who presented to the Emergency Department with complaints of urinary symptoms including dysuria, hematuria, urgency, frequency, malodorous urine, or suprapubic discomfort were offered gonnorhea and Chlamydia testing using one of the following three methods: dirty urine sample, vaginal self-swab, or provider-obtained cervical swab.

Results

Over the course of one month, 15 female volunteer patients were tested for gonorrhea and Chlamydia. One patient was positive for Chlamydia and treated appropriately. No patients tested positive for gonorrhea. 11 of 15 patients had a diagnosis of urinary tract infection and would not have been tested for gonorrhea or Chlamydia using previous protocol.

Discussion

The goal of this project was achieved in that testing was increased among high-risk patients. Due to the limited amount of data, though, it cannot be said whether there was an increase in diagnosis rates compared to before.

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