The hepatitis C virus (HCV) disproportionately affects the prison population. Studies demonstrate that healthcare provider knowledge of HCV risk factors is insufficient and many individuals are not aware that they are HCV positive. Early identification of HCV status can prompt early treatment and avoidance of complications that contribute to poor outcomes resulting in chronic disease progression. This doctor of nursing practice (DNP) project addresses provider identification of HCV risk factors at initial inmate intake to prison and whether providers obtained HCV testing based on guidelines from the Centers for Disease Control and Prevention (CDC). The principal investigator (PI) conducted a retrospective medical record review at Arizona State Prison Complex (ASPC) Lewis focusing on initial inmate intake forms identifying two of the CDC risk factors for HCV: drug abuse and tattoos; and ascertaining if a providers ordered a HCV test if inmates had one or both of these risk factors. The PI reviewed 51 randomly selected medical records; 40 records met inclusion criteria of 1) inmates who had an initial inmate intake evaluation occurring from 1 October 2013 to 1 October 2014 and 2) documentation of positive HCV risk factors. Analysis of the records showed a mean inmate age of 26.78 years with a variable racial distribution. The risk factor of tattooing was present in 37 (92.5%) of records reviewed and the risk factor of intravenous drug use (IVDU) was present in 7 (17.5%). Only 4 (10%) records of inmates with positive risk factors had a HCV test ordered by the provider: One physician (n=2) and one nurse practitioner (n=2). This project demonstrated a gap in HCV testing in the presence of risk factors in the inmate population at ASPC Lewis which is consistent with studies in the general population. This study does not identify any reasons for this consistency, but raises questions for future studies focused on provider knowledge, education and the institution of HCV testing protocols. This DNP project provides the foundation for a future full quality improvement Plan-Do-Study-Act based project aimed at educating providers about HCV testing according to CDC (2013a) guidelines and subsequently re-evaluating their HCV test ordering practices.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/560731 |
| Date | January 2015 |
| Creators | Thompson, Susan Lynn |
| Contributors | Loescher, Lois J., Martin-Plank, Lori, Armbsruster, Charlotte, Loescher, Lois J. |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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