Year of Publication

2022

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sheila Melander

Clinical Mentor

Dr. Patricia K. Howard

Committee Member

Dr. Candice D. Falls

Committee Member

Dr. J. Daniel Moore

Abstract

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an attempt at increasing patient knowledge of hepatitis C through informative flyers in treatment areas would increase linkage to care and successful follow-up rates after receiving a positive diagnosis. Specific objectives include to 1) increase bedside nurse and ED provider compliance in ordering HCV tests and communicating positive test results and follow-up care information to our patient population, and to 2) disseminate educational materials to patients regarding HCV transmission and complications if left untreated to increase linkage to care rates.

Methods: This project is a single-site, multimodal project designed to both examine the impact of an education intervention via informal staff in-services using a pre- and post-survey as measurement, and to utilize a secondary data analysis approach to compare linkage-to-care rates following distribution of educational information to patients. The project examined cross-sectional survey responses obtained from clinical staff in the ED, as well as tertiary data obtained from deidentified patient chart reviews.

Results: A total of 49 staff members completed the pre-survey and 48 staff members completed the post-survey following 10 educational in-services. Statistically significant changes were observed in testing compliance (p = .028) and reported feelings of confidence with HCV knowledge and testing/ diagnosis ( p = .016). A relative increase in the number of patients tested was observed in Dec. 2021 and January 2022.

Conclusion: Knowledgeable and confident healthcare providers are vital for improving patient outcomes and can be achieved through in-services. Future research should focus on continued staff education, implementation of dedicated patient navigators, and tackling the barriers of successful follow-up.

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