ARCHI_project_STI_referral

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Streamlining the referral pathway
from the Emergency Department
to the Sexual Health clinic
Place AHS Logo
Here
Lorraine Harry, ED Clinical Nurse Specialist 2 Emergency, and
Alison Mears, CNC HIV Sexual Health, HIV and Related Programs, (HARP)
Hastings/Macleay Network, MNC LHD
Introduction
Community members often present at
the local hospital Emergency
Department (ED) with a history or
symptoms that prompt clinicians to
carry out pathology testing for sexually
transmitted infections (STI). Once a
clinician commences investigations for
STI’s, and particularly if a positive
result is found, then the clinician has a
responsibility to follow up with this
patient. This kind of follow up is time
consuming and not really the core
business of the ED staff.
In the Hastings Macleay Network of
the Mid North Coast Local Health
District there is a sexual health clinic,
Clinic 33, that can help ED staff with
this exact follow up, including following
up with the patient re treatment and
initiating any contact tracing required.
At present there is no formal referral
pathway from ED the Clinic 33.
Results
100% of referrals fell into a HIV and Related Programs target groups, which include
Members of Aboriginal community
Youth
People infected with STI
100% of positive results had appropriate follow up and contact tracing attended
Outcomes
20
18
16
14
12
Clinic 33 Referrals
meets HaRP Target Group
Positive Result
Contact Tracing attended
10
8
6
4
2
0
January to April 2012
Aim
Patients presenting to Kempsey
District Hospital Emergency
Department who have pathology
testing for sexually transmitted
infections are referred to Sexual
Health for follow up (excluding
pregnancy and sexual assaults <16yrs
of age).
Method
In consultation with key stake holders,
a referral form was developed and
trialled in ED. The referral form also
acted as a guide to inform ED staff of
what tests are considered best
practice in different circumstances,
and also information on current
treatments for STI’s.
Conclusion
ED staff are now more aware of and
more confident to address STI
assessment, testing and treatment
within the Emergency Department
setting. Patients presenting to ED who
are referred to Sexual Health for follow
up of STI screening are contacted,
symptoms discussed, information
provided, appointments offered as
appropriate, and importantly, contact
tracing of people with positive STI
pathology is attended
Acknowledgements
Leanne Wright, ED Nurse Practitioner
Kerryn Bullivant, ED NUM, KDH
Janet Knox, Staff Specialist Sexual
Health, HARP
Tim Platt, Medical Director of Kempsey
Emergency Department
Allan Forrester Network Medical
Director of Hasting/Macleay
Emergency Departments
Contact Details
Alison Mears, Team Leader/CNC HIV and Sexual Health
Clinic 33 Hastings/Macleay Sexual Health Service
Clinic 33, Kempsey Community Health, Polwood St, Kempsey, 2440, NSW
Tel. 02 6562 6066 | Fax. 02 6562 8116 | Mob. 0418 207 939
Alison.Mears@ncahs.health.nsw.gov.au
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