The Health Center will provide quality health care services.

The Health Center will implement a Complete Blood Count analyzer machine.

The indicators for this objective is the successful implementation of a CBC analyzer machine by the end of FY 2014.

The Health Center purchased and installed the Complete Blood Count Analyzer machine on January 9, 2014. A quality control study was conducted after installation. Correlation studies were performed and plotted. The mean and percent difference was calculated for each analyte and the result was within the limits of acceptability. A graph was plotted which shows the values and how they fell within the low and high limits.

The test and outcomes were as follows:

1. 16 practice patients had their blood drawn to compare to a send out analysis versus an in house analysis. 4 runs were grouped of 4 patients and an analysis was performed to distinguish RBC, WBC, HGB, and PLT. The results established that all 4 runs of each type of test were within the parameter limits.

2. Since the initial installation of the product, 604 patients have been positively impacted by the implementation of this machine. The ease and turnaround time of results have allowed providers to appropriately diagnose whether the patient has a viral or bacterial infection. Additionally, the providers have been able to prescribe medications accordingly to minimize the patient to over exposure to antibiotics.

Since the implementation of the analyzer, the laboratory has recognized a time management issue. The results that the laboratory technician receives takes a manual entry time of 8-10 minutes per patient given there is not another patient's blood waiting to be processed. In the case that another patient needs their blood processed, the entire process can take up to 30-45 minutes for a provider to the receive the results. The system will allow an interface exchange between the Electronic Health Record and the Emerald CBC Analyzer. The Health Center will look at the ability to interface between the products to allow a better workflow process to expedite the patient results.  

Additionally, at times the CBC may not fully read the results of the patient's blood count. Depending on the instance, a 5-part differential reading is necessary. When this occurs, the medical technologist must find the ordering provider and receive verbal orders to initial a CBC send-out test. This takes significant time on behalf of the medical technologist, provider, and patient. A laboratory standing order will be created to expedite this process.  

The Health Center will engage in a quality improvement activity.

The indicator for this objective is the quality improvement study report. Our goal is to conduct one quality improvement study during FY 2014.

The Health Center completed one quality improvement study.  The study assessed an internal benchmarking review of processes and outcomes based on a FY13 study assessing Administration of Allergy Injections. 

The study found the following:
1. There were a total of 19 charts reviewed. Patient compliance with the ordered schedule of administration was 53%.  This results in the nursing staff adjusting the dosage of serum in accordance with each Allergist’s guidelines or having to contact the ordering Allergist’s office for new orders.

2. All new orders to continue allergy injection therapy at the SHC were reviewed by the Medical Director.  100% of the students were compliant with the current policy of having a clinic visit with a provider prior to beginning their injections at the SHC.

3. After the initial visit, the nurse presented the student welcome kit to 100% of patients and all forms were reviewed and signed, along with the patient responsibility form. 100% of the charts had allergist orders and written protocols present. 84% of the allergist protocols had the patient ID documented. 100% of patients had the serum expiration documented on the EHR and the serum vial.

4. The documentation of allergy injections on the patient’s EHR chart was present 100% of the time and 95% of the time on the allergist’s paper forms.  However, post-injection reactions were documented in the EHR 83% of the time.  One patient in particular did not stay to have their sight checked, causing a skew in results. This particular case was documented in their post-injection form.

They study completed this year outlined quality improvement processes that yielded the following actions:

1. Document on EHR and allergist form to ensure accuracy.

2. Post injection assessment should be documented 100% of the time.  If the patient leaves before the nurse has evaluated the injection site, then that notation should be made.  All injections should have a notation or response documented.

3. Assign one nurse to check the expiration allergy serums every month and document it on a designated form.  All expired serums should be immediately destroyed, documented as destroyed in the medical record, and the student notified.

4. Consider having only the Registered Nurses housed in the Nursing Clinic assigned to manage the allergy clinic. 

5. Consider opening the EHR to allow patient self-scheduling for the allergy clinic to encourage patient compliance and easier access.

6. Consider conducting a follow-up review once the new SHC has opened and the additional 2 RNs are hired and trained.

The Health Center will equip and encourage students to make healthy lifestyle choices.

The Health Center will conduct outreach activities that improve students' knowledge of healthy behaviors and assist students in identifying ways to improve their behaviors.

The assessment for the sexual wellness program presentation will result in:
1. 85% of participants acknowledging that they are aware of the free STI program.

2. At least 30% of those that acknowledged the program will participate in the free testing event.  

1. 94% of participants acknowledged they were aware that there was a Free HIV and Syphilis testing program.

2. The participation in the Free STI testing program immediately following the 'What Sex Can Do To You' presentation experienced 60% participation from those that acknowledged the program. Each participant received information and engaged in conversation about sexual wellness and healthy sexual behaviors.

The testing identified 2 carriers of Syphilis and 2 carriers of HIV. The Student Health Center, along with the Texas Department of State Health and Services, educated the carriers and their previous/current partners about the importance of sexual wellness, healthy lifestyles, and treatment options. Although these types of STIs are serious and potentially life-threatening, the students engaged in serious conversations about their future lifestyles and identified ways to change their current behaviors and attitudes.

The department met the goals of:
1. 85% of participants acknowledging that they are aware of the free STI program, with a result of 94%.

2. 30% of those that acknowledged the program will participate in the free testing event with a result of 60% participation.

Although the goals were met, we investigated in the open ended comments to see why 100% of participants were not aware of the program. Some of the answers reflected boredom and/or comments that appeared to have negative attitudes toward the program.

The program was expanded this year to a two day clinic unlike previous years that yielded a one day clinic. The increase in participation compared to FY13 showed a dramatic increase in participation. FY12 resulted in 120 students participating for one day clinic and FY13 increased by 269 more participants in a two day clinic. Due to the overwhelming response, the department will investigate methods of outreach opportunities to educate the student body as a whole about sexual wellness and the impacts of risky behaviors.