Implementation of a Standardized Screening Protocol to Improve Post-traumatic Stress Disorder Surveillance in First Responders.

OBJECTIVE: The purpose of this quality improvement project was to implement a standardized screening protocol to identify post-traumatic stress disorder (PTSD) in first responders during employment physicals in a primary care setting. METHODS: A pre-/post-intervention project design was used, utilizing the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (PCL-5) screening tool. Outcome measures included screening completion, positive screening rate, and referral rate. RESULTS: A total of 331 first responders presented for employment physicals. In the post-intervention cohort, 96% (152/158) of first responders were screened. From pre- to post-intervention, first responders who screened positive increased from less than 1% (1/173) to 4.6% (7/152). Of those screening positive, a total of five of seven (71%) patients were referred for mental health evaluation. CONCLUSIONS: A standardized screening protocol using a validated self-assessment tool improved PTSD surveillance in first responders and triggered referral.

Syphilis: A growing concern.

Since a brief low in 1998, reported cases of syphilis have continued to grow in the US. As primary care providers, NPs are at the forefront of the battle to eliminate syphilis. This article reviews the stages of this infection, diagnosis nuances, and treatment guidelines.