Improving Adherence to Sexually Transmitted Infection Retesting Guidelines at a Sexual Health Clinic

Objective

To increase sexually transmitted infection (STI) retesting rates by 50% at a sexual health clinic.

Design

Preintervention and postintervention comparison to evaluate STI retesting rates before and after a 4-month intervention period.

Setting/Local Problem

A nonprofit clinic offering sexual health services to clients ages 12 to 26 years in Hennepin County, MN; this clinic had low rates of STI retesting.

Participants

Six registered nurses who provide direct nursing care at the clinic.

Intervention/Measurements

This quality improvement (QI) project implemented low-cost interventions to achieve the project goals. One set of reminder-based interventions involved implementing a new STI follow-up protocol with a shift to text message reminders and new electronic health record alerts. Another set of education-based interventions included training staff and providing clients with new education materials.

Results

The average STI retesting rate increased from 31.91% in the preintervention period to 46.81% in the initial intervention period and 51.51% in the full intervention period. A test of two proportions demonstrated a statistically significant change between the baseline and intervention groups at a p < .05 level, z (–2.41), p = .02, 95% CI [–0.29, –0.03]. Qualitative data from the six nurse survey responses demonstrated positive attitudes toward the interventions.

Conclusion

Results of a multifaceted quality improvement project aiming to increase STI retesting rates exceeded the project goal. Nurses were receptive to the changes, and the interventions did not require excess time or money. These results demonstrate that clinics can easily integrate low-cost interventions aimed at reducing the STI disease burden in their communities.