Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Grace Gao


Doctor of Nursing Practice


Background: Sexually transmitted infections (STIs) may result in adverse reproductive health outcomes and the prevalence of such infections is rising despite public health efforts. The Centers for Disease Control and Prevention recommend retesting for repeat infection three months after the initial infection as a means of decreasing the STI burden.

Problem: STI retesting rates at the project site are suboptimal and the follow-up process for contacting clients can be streamlined.

Methods: This quality improvement (QI) project implemented low-cost reminder and education-based interventions to achieve the project goals. Reminder-based interventions included implementing a new STI follow-up protocol with a shift to text message reminders and new electronic health record clinical decision support tools. Education-based interventions included staff training and new client education materials.

Results: The average STI retesting rate increased from 31.4% in the pre-intervention period to 47.0% in the initial intervention period, to 67.6% in the full intervention period. A test of two proportions demonstrated a statistically significant change between the baseline and intervention groups (Z = -2.46, p = .014, 95% CI [-0.289, -0.033]). The Statistical Process Control p-Chart did not demonstrate any sources of special cause variation. Qualitative data from nurse survey responses (N = 6, RR 100%) demonstrated positive attitudes towards the interventions.

Conclusion: A multifaceted QI approach to increasing STI retesting rates demonstrated a statistically significant improvement. Nurses were receptive to the changes, and the interventions did not require excess time or money. This QI initiative demonstrates that clinics can easily integrate low-cost interventions in reducing the STI disease burden in their communities.

Available for download on Friday, August 01, 2025