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Increasing Vaginal Chlamydia Trachomatis Testing in Adolescent and Young Adults.
- Source :
-
Pediatrics [Pediatrics] 2020 Aug; Vol. 146 (2). Date of Electronic Publication: 2020 Jul 07. - Publication Year :
- 2020
-
Abstract
- Objective: The Centers for Disease Control and Prevention recommend testing for Chlamydia trachomatis in sexually active female patients <25 years old using nucleic-acid amplification tests (NAAT) from a vaginal swab. Our providers were typically testing using the less sensitive urine NAATs. We aimed to increase the percentage of urogenital C trachomatis NAATs performed by using vaginal swabs in adolescent female patients ages 10 through 20 years from 1.4% to 25%.<br />Methods: We implemented 3 interventions at 3 pediatric practices over 12 months including education, process standardization, and cross-training. We used statistical process control to analyze the effect of interventions on our primary outcome: the percentage of urogenital C trachomatis tests performed with a vaginal swab. Our balance measure was the total number of urogenital C trachomatis tests.<br />Results: There were 818 urogenital C trachomatis tests performed: 289 before and 529 after the first intervention. Of urogenital C trachomatis tests in the preintervention time period, 1.4% were performed by using vaginal swabs. We surpassed our aim of 25% 6 weeks after the first intervention. We noted sustained improvement after the second intervention, with an average of 68.3% of tests performed by using vaginal swabs for the remaining postintervention period. There was no difference in the overall number of urogenital C trachomatis tests pre- and postintervention.<br />Conclusions: Using quality improvement methodology and implementing easily replicable interventions, we significantly and sustainably increased use of vaginal swabs. The interventions standardizing processes were associated with a higher impact than the educational intervention.<br />Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.<br /> (Copyright © 2020 by the American Academy of Pediatrics.)
- Subjects :
- Adolescent
Child
Chlamydia Infections epidemiology
Female
Humans
Massachusetts epidemiology
Nucleic Acid Amplification Techniques statistics & numerical data
Pamphlets
Practice Guidelines as Topic
Practice Patterns, Physicians' statistics & numerical data
Procedures and Techniques Utilization trends
Program Evaluation
Quality Improvement
Sexual Behavior
Young Adult
Chlamydia Infections diagnosis
Chlamydia trachomatis isolation & purification
Nucleic Acid Amplification Techniques methods
Pediatricians education
Practice Patterns, Physicians' trends
Vagina microbiology
Vaginal Smears trends
Subjects
Details
- Language :
- English
- ISSN :
- 1098-4275
- Volume :
- 146
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 32636237
- Full Text :
- https://doi.org/10.1542/peds.2019-3028