Date Available

12-5-2016

Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julianne Ossege

Clinical Mentor

Dr. Michelle Pendleton

Committee Member

Dr. Sharon Lock

Committee Member

Dr. Kim Tharp-Barrie

Abstract

Purpose: The purpose of this study was to evaluate primary care provider screening for hepatitis C virus (HCV) in three high risk populations. The specific aims were to determine the percentage of patients born between 1945-1965 who had a one-time screening for HCV, to determine what proportion of patients with a history of human immunodeficiency virus (HIV) or intravenous drug use (IVDU) have been screened for HCV, and to examine providers’ thoughts on their HCV screening practices.

Methods: A retrospective chart review of patient electronic medical records (EMR’s) from 2015 was conducted in an urban primary care site. SPSS was used to analyze the data. A provider survey was conducted to assess comfort, familiarity, and adherence with screening recommendations.

Results: The sample demographics were very similar to the total population of the practice. Of the birth cohort, it was determined that 6.1% were screened per the USPSTF recommendations. The HIV positive and IVDU groups were very small and either were not screened at all or were screened by a specialist. Of the individuals screened, 16.7% were positive for HCV. The provider survey demonstrated belief that screenings were done per recommendations. Barriers to screening according to the recommended guidelines included coding and insurance denials for screenings. The provider survey suggested acknowledged an EMR trigger would assist in prompting more screenings.

Conclusion: The study demonstrates there is opportunity to improve screening rates of the birth cohort. There is insufficient evidence to determine if there are gaps in screening HIV and IVDU. Future studies should focus on additional high risk groups with larger sample sizes.

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