189 Practice Patterns and Attitudes Towards Universal Sexually Transmitted Infection Screening in a Pediatric Emergency Department

Abstract

Adolescents have the highest rates of sexually transmitted infections (STIs) and often use the emergency department (ED) for care, thus rendering the ED a strategic setting for STI screening. Unfortunately, STI testing is not routinely conducted in the ED. The objective of this study was to explore clinician attitudes towards STI screening in an urban pediatric ED. This was a mixed methods study using electronic surveys, focus groups, and semi-structured interviews with clinicians from an urban pediatric ED. We examined STI screening practices, attitudes, and perceived barriers and facilitators towards screening. 78 of 86 (90.7%) clinicians participated in the survey and 23 participated in either focus groups or semi-structured interviews. Approximately half (56.4%) of clinicians reported always/most of the time screening all adolescents for STIs during an ED visit, regardless of complaint. The majority of clinicians (84.6%) agreed that STI screening is beneficial, and that the ED is an appropriate venue for screening (75.6%). Qualitative analysis revealed the following themes with regards to barriers towards ED-based STI screening: limited resources, disruption to work flow, and follow-up concerns. Almost all (95%) agreed that use of electronic clinical decision support to guide STI screening would facilitate STI testing. ED clinicians believe that ED-based STI screening is important, but resources in the ED are limited. Almost all clinicians believe that electronic clinical decision support would facilitate STI screening.