Author

Sherry Katz

Date

5-2015

Document Type

Thesis

Degree Name

D.N.P.

Institution

Oregon Health & Science University

Abstract

The resource center clinic implemented a health-screening program for the population of people experiencing homelessness or precarious housing situations. One of the program intentions was to align service with BCMH and MCFD goals of increased accessibility, increased screening and preventative health care services, and increased integration of primary care and mental health and substance use services. The clinic hours are limited and available Wednesday mornings from 0830 until noon. On average 7 new patients were seen each month. The patient population was predominantly male, the average age was 45.6, and 50% were homeless. There was a high prevalence of prehypertension and prediabetes. Eighty five percent of patients had a positive screen for depression and this was higher than expected. Polysubstance use was more common for the patients as compared to use of alcohol only. The number of patients with positive HCV screening was within the expected range. Seventy nine percent of patients seen in the clinic for screening smoke cigarettes.

Patients with prediabetes and prehypertension require more frequent screening. Further assessment and intervention with regards to nicotine dependence is needed. For patients presenting with depression, the addition of group or online CBT could help improve outcomes. In order to improve the health outcomes for HCV positive patients it is important to develop links with clinics offering support and treatment for HCV. To improve the health of this population we need to increase the number of clinic hours and offer clinic time later in the day. Additionally, reducing barriers to screening such as offering non-fasting lab tests, using a one page tool that incorporates screening for depression, alcohol use and substance use, and having one key person completing the initial screening may increase consistency and patient participation.

Identifier

doi:10.6083/M4H41Q72

School

School of Nursing

Included in

Nursing Commons

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