Appropriate CT/GC Screening & Factors to Consider

Becky McCoy MSN, RN, CEN

STD Nurse Consultant

Infertility Prevention Project

“IPP” The CDC in collaboration with the Office of Population

Affairs of the Department of Health and Human Services supports the program.

Promotes (and funds!) women's reproductive & sexual health via chlamydia/gonorrhea screening & treatment.

Services are intended for low-income, sexually active women attending public clinics (family planning) to prevent infertility.

Who Do We Need To Screen ?

Females age 25 and younger:

Does FP clinic have high positivity (> 3%) ?

If so, perform routine CT/GC screening

Females age 26 and older:

Do not conduct routine screening

Test if sx are reported or observed

Test if there is a new partner or multiple partners in previous 60 days

Test if exposure to an infected individual

Screening Statistics ~ What Do We Look At ??

Essentially divided into 2 groups of data:

Females 25 years and younger

Females 26 years and older

Data ~ 25 and Younger

We look at:

Total number tested

Number of “positives” from those tested

Positivity rate

Sites identified with low positivity (< 3 %) should cease routine screening & perform targeted screening, i.e. pt complaint of sx, observation of sx, new or multiple partners within previous 60 days or exposure to infected individual

Data ~ 26 and Older

We look at:

Total number tested

Number of “positives” from total number tested

Positivity rate

Testing should be conducted only if patient is determined to be “at-risk” based on previously indicated criteria, i.e. symptoms, new or multiple partners in previous 60 days or exposure to infected individual

Fiscal Impact

STD Program in Frankfort contributes approximately $400,000 annually via CDC-STD grant to support the program, i.e. purchase test kits.

Current contract price for each CT/GC test kit is approximately $9.60 per kit. Keep in mind that this is the kit only – does not include labor nor costs at the state lab for actual testing

Local Effect

Decreasing public health dollars

Competing priorities

Recent updates from CDC emphasizing federal goal of avoiding duplication, stating CDC funding should not be used to provide clinical services

Increased emphasis on cost-effective screening, screening rates and timely treatment

Factors to Consider

Are we using test kits / IPP services to process testing for patients with health insurance, Medicaid, etc?

What type of billing systems or process is in place to recover such funds?

What screening tool is in place to assess need for testing prior to collection of specimens ~ use of test kit?

Need for education of all staff regarding significance of appropriate screening & testing

What’s Next?

Be proactive instead of reactive!

Identify as a team what will work best for your individual facilities and implement appropriate interventions.