Development and Implementation of Hepatitis C Virus Screening Policy to Improve Screening Rates in Adults 18-79 Years Old.

Abstract

Background: People with newly acquired hepatitis C virus (HCV) infections are usually asymptomatic and unaware of the disease. Approximately 70%-85% of people infected with the virus develop a chronic infection causing severe long-term health problems. The incidence rate of hepatitis C infections in Kern County is higher than the State of California's overall rate. In Kern County, a 31% increase in the incidence rate of HCV infections occurred from 2014 to 2018 compared with a 3% increase in California. Objective: This study aimed to improve HCV screening rates in patients 18-79 years old at a family practice clinic. Methods: A descriptive practice change design used a retrospective and prospective method to compare HCV screening rates pre- and postintervention of an office policy implementation combined with provider education. Results: In 400 patients in the age group of 18-79 years treated at the clinic in October 2020, 4 weeks before the policy change project implementation, 1.0% of the cohort was screened for HCV. In the postintervention period, 30% of the 44 eligible patients were screened. The increase in the percentage of the cohort screened from 1.0% to 29% was significant (χ² [df = 1] = 87.719, p < .001). Conclusion: The education of the health care team to ensure buy-in and understanding of the clinical practice change and the development and implementation of a new screening policy yielded an enhanced HCV screening rate at this family practice clinic. Implications for Nursing: Advance practice registered nurses (APRNs) can significantly participate in the reduction of poor health outcomes related to chronic HCV infection by consistently screening all qualified patients between the ages of 18 and 79 years by 2030. APRNs can join the call to action by providing HCV screening services at a local level.