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Compliance with the Centers for Disease Control and Prevention recommendations for the diagnosis and treatment of sexually transmitted diseases.
Acad Emerg Med. 2004 Apr; 11(4):371-7.AE

Abstract

Little is known about gaps in quality and the extent to which clinical standards are used in emergency department (ED) practice.

OBJECTIVES

To determine whether ED practitioners comply with the Centers for Disease Control and Prevention (CDC) recommendations for diagnosing and treating sexually transmitted diseases (STDs).

METHODS

A retrospective chart review of ED visits was conducted at an urban teaching hospital. Using ICD-9 codes, urethritis, cervicitis, pelvic inflammatory disease (PID), gonorrhea, and chlamydia cases seen from May 1, 2000, to February 28, 2001, were identified. Documentation of components of the history, physical examination, diagnostic testing, prescribed antibiotics, and discharge instructions necessary to comply with the CDC guidelines were abstracted. This set of comprehensive criteria was compared with a less stringent subset of selected criteria.

RESULTS

Two hundred forty-six patient visits were identified, and 203 (83%) were included. Forty-eight men and 155 women were included: 48 (24%) with urethritis, 34 (17%) with cervicitis, and 121 (60%) with PID. For urethritis, cervicitis, and PID, respectively, there was documentation of compliance with indicators related to the following: history 73%, 15%, and 14%; physical examinations 63%, 15%, and 22%; diagnostic testing 79%, 71%, and 71%; antibiotic use 33%, 32%, and 32%; and safe sex instructions 50%, 18%, and 15% of the time. Men were more likely to receive safe sex instructions (p < or = 0.01). Total (100%) compliance in all five domains occurred 8% of the time for urethritis, 3% for cervicitis, and never for PID. The rates of 100% compliance were not significantly different when a subset of selected criteria was used.

CONCLUSIONS

Deficits in adherence to recommended guidelines for the diagnosis and treatment of STDs exist in ED practice.

Authors+Show Affiliations

Department of Surgery, Section of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, New Haven, CT 06519, USA. bryan.kane@lvh.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15064211

Citation

Kane, Bryan G., et al. "Compliance With the Centers for Disease Control and Prevention Recommendations for the Diagnosis and Treatment of Sexually Transmitted Diseases." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 11, no. 4, 2004, pp. 371-7.
Kane BG, Degutis LC, Sayward HK, et al. Compliance with the Centers for Disease Control and Prevention recommendations for the diagnosis and treatment of sexually transmitted diseases. Acad Emerg Med. 2004;11(4):371-7.
Kane, B. G., Degutis, L. C., Sayward, H. K., & D'Onofrio, G. (2004). Compliance with the Centers for Disease Control and Prevention recommendations for the diagnosis and treatment of sexually transmitted diseases. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 11(4), 371-7.
Kane BG, et al. Compliance With the Centers for Disease Control and Prevention Recommendations for the Diagnosis and Treatment of Sexually Transmitted Diseases. Acad Emerg Med. 2004;11(4):371-7. PubMed PMID: 15064211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Compliance with the Centers for Disease Control and Prevention recommendations for the diagnosis and treatment of sexually transmitted diseases. AU - Kane,Bryan G, AU - Degutis,Linda C, AU - Sayward,Helen K, AU - D'Onofrio,Gail, PY - 2004/4/6/pubmed PY - 2004/8/11/medline PY - 2004/4/6/entrez SP - 371 EP - 7 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 11 IS - 4 N2 - UNLABELLED: Little is known about gaps in quality and the extent to which clinical standards are used in emergency department (ED) practice. OBJECTIVES: To determine whether ED practitioners comply with the Centers for Disease Control and Prevention (CDC) recommendations for diagnosing and treating sexually transmitted diseases (STDs). METHODS: A retrospective chart review of ED visits was conducted at an urban teaching hospital. Using ICD-9 codes, urethritis, cervicitis, pelvic inflammatory disease (PID), gonorrhea, and chlamydia cases seen from May 1, 2000, to February 28, 2001, were identified. Documentation of components of the history, physical examination, diagnostic testing, prescribed antibiotics, and discharge instructions necessary to comply with the CDC guidelines were abstracted. This set of comprehensive criteria was compared with a less stringent subset of selected criteria. RESULTS: Two hundred forty-six patient visits were identified, and 203 (83%) were included. Forty-eight men and 155 women were included: 48 (24%) with urethritis, 34 (17%) with cervicitis, and 121 (60%) with PID. For urethritis, cervicitis, and PID, respectively, there was documentation of compliance with indicators related to the following: history 73%, 15%, and 14%; physical examinations 63%, 15%, and 22%; diagnostic testing 79%, 71%, and 71%; antibiotic use 33%, 32%, and 32%; and safe sex instructions 50%, 18%, and 15% of the time. Men were more likely to receive safe sex instructions (p < or = 0.01). Total (100%) compliance in all five domains occurred 8% of the time for urethritis, 3% for cervicitis, and never for PID. The rates of 100% compliance were not significantly different when a subset of selected criteria was used. CONCLUSIONS: Deficits in adherence to recommended guidelines for the diagnosis and treatment of STDs exist in ED practice. SN - 1069-6563 UR - https://www.unboundmedicine.com/medline/citation/15064211/Compliance_with_the_Centers_for_Disease_Control_and_Prevention_recommendations_for_the_diagnosis_and_treatment_of_sexually_transmitted_diseases_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=1069-6563&amp;date=2004&amp;volume=11&amp;issue=4&amp;spage=371 DB - PRIME DP - Unbound Medicine ER -