I’m Too Sexy For My … Taking A Sexual History In The Hospital Setting To Capitalize On A Missed Opportunity

• Published in: Pediatrics (Evanston) 2019-08, Vol.144 (2_MeetingAbstract), p.484-484
• Main Authors: McFadden, Vanessa, Stephany, Alyssa, Pickett, Michelle, Schmitz, Anna, Mehta, Sonia
• Format: Article
• Language: English
• Subjects: Adolescents; Demographics; Demography; Documentation; Electronic medical records; Females; Hospitalization; Ingestion; Intensive care; Intervention; Males; Patients; Pediatrics; Reproduction; Reproductive health; Teenagers; Workflow
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.144.2MA5.484

Background: Half of all new sexually transmitted infections occur among 15-24 year olds and 1 in 4 adolescent females has an STI. Adolescents are known to have poor access to reproductive health care. Hospitalized adolescents are a captive audience, yet reproductive healthcare is not often discussed during hospitalization as preliminary research, from our institution, demonstrated only 55% of hospitalized adolescents had any documentation of sexual history, with males, patients admitted directly to the intensive care unit (ICU), and those hospitalized for non-ingestion complaints, with even less documentation. Objective: The objective of this study was to increase the percentage of documented sexual history for adolescents aged 13 years old and older hospitalized on the hospital medicine service. Design/Methods: This is a prospective study from 5/1/17 to 12/31/17 at a stand-alone academic children's hospital, with baseline data from 5/1/17 to 7/30/17 and post intervention data from 11/20/17 to 12/31/17. Interventions consisted of: resident education including evidence-based reasons for taking a sexual history in hospitalized adolescents and presentation of current institutional practice habits, and development of electronic health record template to facilitate intervention implementation workflow. Data collected included patient demographics and sexual history defined as any documentation of sexual history within the entire hospital encounter. Subgroups analyzed were males, patients admitted directly to the intensive care unit (ICU) then transferred to the acute care unit, and those hospitalized for non-ingestion complaints. Data was analyzed using descriptive statistics and unpaired T tests to determine changes in sexual history documentation post intervention. Results: 150 patients were included in the baseline data and 51 patients in the post-intervention. Overall, documentation of sexual history significantly increased from 55% to 75%, p=0.02. Documentation in males increased from 36% to 53%, p=0.22, and for patients initially admitted to the ICU then transferred to the acute care unit increased from 14% to 33%, p=0.36, but both were not significant. Documentation for non-ingestion complaints significantly increased from 48% to 73%, p