Paper
Thursday, July 12, 2007
Evaluating evidenced-based guidelines for the treatment of congenital syphilis in a community
Elizabeth T. Jordan, DNSc, RNC, Maternal Child, Johns Hopkins University School of Nursing, Baltimore, MD, USA
Learning Objective #1: describe evidence-based guidelines for treating congenital syphilis. |
Learning Objective #2: describe a framework used to evaluate the
effectiveness of evidence-based guidelines for treating congenital syphilis in a community.
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Nurses working in public health strive to achieve health improvement. Therefore, nurses must be willing to evaluate the effects of public health actions. The purpose of this presentation is to describe how using a program evaluation framework evaluates the effectiveness of evidence-based guidelines for the treatment of congenital syphilis in a community. Effective prevention and detection of congenital syphilis depends on the routine serologic screening of pregnant women during the first prenatal visit. In populations in which prenatal care is not optimal, screening and treatment should be performed at the time pregnancy is confirmed. For communities and populations in which the prevalence of syphilis is high or for patients at high risk, serologic testing should be performed twice during the third trimester at 28 weeks’ gestation, and at delivery in addition to routine early screening.1 Any woman who delivers a stillborn after 20 weeks’ gestation should be tested for syphilis. If an infant's status has not been determined at least once during pregnancy then prior to discharge of the infant from a birth site a maternal serologic status should be determined.Using evidence-based guidelines developed by the Center for Disease Control helps practitioners determine the treatment and counseling of pregnant women and newborns.Evidence-based guidelines helps guide consistent care and strengthen collaborations with health-care providers and public health programs. Increasing provider awareness of Primary and Secondary syphilis has demonstrated increase case reporting, which is essential to successful partner notification and treatment activities implemented by local health departments. By using a framework to evaluate the care and treatment of congenital syphilis, public health nurses identify steps and activities of the guidelines that were not followed. The lessons learned from evaluations will improve case identification and reporting, partner-notification programs and treatment of congenital syphilis in the community.