Third Trimester Syphilis Testing at Urban and Suburban Obstetric Clinics: A Quality Improvement Project

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Third Trimester Syphilis Testing at Urban and Suburban Obstetric Clinics: A Quality Improvement Project Danielle Bennett, BSN, RN, PMH-DNP(S); Marcela Smid, MD, MS, MA; Cynthia Garbett, DNP, APRN, PMHNP-BC . Key Take Away Surveys, education, toolkits, and stickers for clinicians can improve third-trimester syphilis testing rates and may decrease congenital syphilis through early treatment and cure during pregnancy. Background • • • Syphilis is a major cause of morbidity and mortality in pregnancy and post-partum, affecting more than 10,000 pregnant people annually Congenital syphilis can be deadly in up to 44% of cases Third-trimester testing increases the likelihood of identifying syphilis with enough time to treat, preventing congenital syphilis Purpose • This Doctor of Nursing evidence-based quality improvement initiative aims to increase third-trimester syphilis testing for pregnant patients at ten obstetric clinics by implementing targeted interventions and clinical engagement strategies • These included toolkits, surveys, education sessions, and sticker distribution Methods • • • • Assess workflow through surveys and interviews to gather information to design toolkits Develop toolkits, clinician education, and additional surveys Implement surveys, interviews, toolkits, toolkit education, and sticker distribution Evaluate changes through electronic medical record chart reviews, surveys, interviews, and regular communication with stakeholders Results • • • • Testing rates improved by about 30% Syphilis testing was integrated into third-trimester order set 100% (n=11) of APPs reported testing in the third trimester (up from 71.4%, n=10) 80.6% (n=29) of medical assistants, registered nurses, and nurse administrators reported feeling very comfortable understanding the Triple-Testing Guidelines (up from 17.1%, n=6) Conclusions • • • • Surveys, education, and toolkits can improve thirdtrimester syphilis testing ”Educating the educator” may improve the long-term integration of intervention Adding syphilis testing to the third-trimester order set may increase long-term compliance with testing guidelines The use of memorable icons (stickers) promotes adherence and investment @uofunursing @utnurseresearch