TITLE OFServices

Syringe
PRESENTATION
Program (SSP)
Name, Jones
Amber
Credentials,
Radcliffe,
TitleRN and Brittany Nave, RN
Introduction

Results

SUBHEAD
TYPE FORMAT
Public
Health
Response to
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Hepatitis
C goes

The Whatcom County Public Health

Department (WCHD) has operated the Syringe
Services Program (SSP) since 1999.
The SSP helps reduce transmission of HCV
and other communicable diseases by providing
persons who inject drugs (PWIDs) with clean
syringes and other supplies meant to support
safe using behaviors.
Rates of HCV infection continue to increase in
Whatcom County (Brockmann, Massanari,
Newell, Phillips, & Drewes, 2012).

Aims

SUBHEAD
FORMAT
AddressTYPE
the following:
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1) Why do HCV rates continue to increase?

2) What are the unmet health needs of this
population?
3) How can the SSP grow?
Method
Written Surveys and Focus Interviews
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Written surveys (n=60) conducted in three separate
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weeks, with brief Plan, Do, Study, Act (PDSA) cycles.
Focus interviews (n=6) conducted without and with
incentives.
Change Theory
Lippetts Seven Phases of Change (Mitchell, 2013)
guided the authors through the survey and
recommendation process. It was selected as it has a
close affinity to the nursing process.

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Active Minds Changing Lives

AA/EO

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Written
Survey
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goes
This
Reported
high
need
for more
syringes (87%)
Most respondents (68%) indicated
reusing syringes
Moderate need for more alcohol
wipes and Narcan
Most respondents reported reusing
and sharing cookers
Cotton fever and abscesses most
cited health issue related to
injection drug use (IDU).
Accessibility barriers
predominately fear of
identification and lack of
transportation.
Most respondents indicated they
had taken brochures home
Almost half indicated they had
used services from brochures
Over half accessed HIV and HCV
screening at WCHD
Of those who hadnt been tested at
WCHD, most screened at an
outside health care agency.

Focus Interviews
Half of participants thought the
Kendall area could use a second
SSP location.
Most thought more days a week
would also be helpful.
Keen insight on the strengths and
struggles of their own
community.

Summary

Logic Model
Statement of Need: Reduce hepatitis C rates in Whatcom County by
improving and expanding the SSP.
Inputs

Strategies/

Outputs

Activities
WCHD staff
(nurses,
administrative,
epidemiologist),
substance use
counselor

Conduct written
survey to collect
information on
SSP areas for
improvement,
barriers to
Syringe Services access, and
Program (SSP) experiences of
clients
volunteers
Focus interviews
Paper,
clipboards, and to elicit clients
pens for survey perceived
strengths and
Computer with struggles
Internet access
to compile and Advertise survey
within waiting
disseminate
area of SSP and
results
encourage
Incentives to get participation
participation in
focus interviews Assess
surrounding
Time for
community and
windshield
resources
survey, to
available to
conduct surveys clients
and focus
interviews, and Literature
review to inform
other activities
activities related
Building/facility to survey
designated for
Request input
exchange
from industry
experts

Number of filled
out surveys and
data compiled in
Survey Monkey,
as well as own
data report
Qualitative data
from focus
interviews with
comments on
trends and
insight
Generate a
community
health
assessment
based on data
gathered from
windshield
survey and
clients
Comparison of
survey
participation
with incentives
and without

Short-term
Outcomes
Identify and
address internal
areas of
improvement

Long-term
Outcomes
Increase access to
SSP, either by
increasing days/
hours of operation
or number of
locations where SSP
is offered

Identify client
learning needs
based on
discrepancies in Provide focused
data and address client education to
with education
address
discrepancies in
Recommend
ways to improve best practice vs.
accessibility to actual practice of
client substance use
SSP
behaviors
Supply tabulated
results of survey Make suggestions
participation to for services offered,
inform whether based on client
feedback
incentives are
necessary
Supply graphs to
show trends in
data from survey

1. HCV Rate Increases: may in part be due to overall, increased number of

SUBHEAD
TYPErate
FORMAT
PWIDs,
high reported
of needle and equipment sharing, and risky behaviors
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TYPE
FORMAT
This
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goes
asThis
indicated
by copy
survey
respondents, barriers to access and a need for clientwhere
focused education.
2. Unmet health needs: respondents indicated cotton fever, abscesses, and
infection secondary to their IDU. Key informant interviews indicated a variety of
unmet health needs, suggesting a need for increased access to client-focused
case management and education.
3. Grow SSP: a need for improved SSP access was a recurring theme of key
informant interviews, who cited barriers to access such as fear of exposure and
transportation challenges and requests for better coverage in the Kendall area.
Respondents also cited a need for opiate substitution treatment. The majority of
respondents also requested more syringes/needles.

C o n c l u s i o n s / Fu r t h e r S t u d y
Recommendations
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TYPEFORMAT
FORMAT
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1.
surveys
to
ascertain use behaviors regarding sharing, cleaning
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goes
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and re-using if IDU equipment. Also further assess needs of rural
clients.
2. Changes to promote improved access to SSP:
User-Driven Model (limitless syringes offered and/or returned)
Current distribution model: one-to-one exchange, max 100 syringes
Mobile Exchange
Coalition building with Phoenix Recovery Services mobile syringe
exchange in the Skagit Valley
Satellite Location
WCHD to continue coalition building with the East Whatcom County
Council for potential development of Kendall location

Acknowledgements
Mentors
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Jessica McAllister, RN, BSN SSP Coordinator
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Nancy Poulin, RN, BSN PHN supervisor
WCHD Staff
Cindy Hollinsworth, RN, MSN Manager of
Communicable Diseases and Epidemiology
Joni Hensley, RN, BSN PHN supervisor
Nicole Willis. MPH - Epidemiologist

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TITLE OF PRESENTATION
Name, Credentials, Title
Introduction

Results

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Aims

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C o n c l u s i o n s / Fu r t h e r S t u d y

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Method

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Acknowledgements

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wwu.edu/bsn

Summary

Active Minds Changing Lives

AA/EO

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