Date of Award

8-2020

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing (Graduate)

First Advisor

Kristen Slabaugh

Abstract

Background: Prior to recent restrictions on travel, international travel was popular with an increasing number of U.S. residents traveling to emerging markets, which may have unfamiliar health risks. In additional to risk of illness, travelers may carry nonendemic disease across country borders, increasing risks to public health. Problem: Though many international travelers report illness during travel or after returning home, only a portion receive a pretravel health consult for preventive care and education. Newer recommendations are to screen for upcoming international travel during routine health contacts; however, a travel medicine provider is best able to perform a comprehensive risk assessment and provide appropriate care. Methods: All adult patients were to be screened for upcoming international travel during each primary care visit at all University of Pittsburgh Medical Center (UPMC) Pinnacle primary care sites – referrals to the Travel Medicine Clinic (TMC) were then given as appropriate. Intervention: A tool to screen for upcoming international travel was embedded into the electronic medical record (EMR) at primary care visits with answers recorded by the rooming medical assistant. For patients with positive screenings, the provider received an immediate EMR prompt for a TMC referral. Results: Analysis of a total quota sample (n=200) found a significant increase in referrals to the TMC [x2 (1) = 118.7, p = .000] with a large effect size (d = .770) in the postintervention group. Additionally, asking about upcoming international travel does have a statistically significant effect on referrals to the TMC [pre group: 0%, n = 0; post group: 93.8%, n – 75, x2 (2) = 29.18, p = .000] with a strong positive association noted (r = .59). Conclusion: Screening for upcoming international travel at primary care visits does increase referrals to the TMC, potentially decreasing risks to travelers and public health.

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