Project description: Nurse led Hepatitis C Clinic – Individuals who use IV drugs are at significant increase risk of transmission and infection of the Hepatitis C virus. At times it proves quite difficult to get clients in for their Hepatitis C blood work screening who are enrolled with the Rapid Access Addictions Medicine (RAAM) clinic. Having capabilities of drawing blood for Hepatitis C screening onsite at the various RAAM clinics would decrease barriers related to transportation to LifeLabs/Lab locations and increase accessibility of screening. 

Purpose: Increase Hepatitis C screening amongst individuals with a current or past history of IV drug use who attend the Brightshores RAAM clinics in Grey/Bruce. 

Expected impact: Increase Hepatitis C screening and therefore cure more cases of Hepatitis C in Grey/Bruce which aligns with the WHOs goal of eradicating Hepatitis C by 2030 

Expected Outcomes & Deliverables:

Anticipated results: 

1. Decrease burden on client by decreasing the amount of different locations they need to attend to get screening for Hep C.  
2. Decrease administration burden on prescribers who often end up completing multiple requisitions for clients who aren’t able to make it to the lab or forget/loose requisitions. 
3. Decrease transportation burden as clients who aren’t able to drive won’t need to book transportation to get to multiple locations.  
4. Contribute to eradicating Hepatitis C as it is a completely curable disease 

Increasing Hepatitis C treatment and management is a goal of the RAAM program. The RAAM Nurses already apart of the RAAM team would increase their skill set by being involved with phlebotomy. Having the capabilities to draw blood at the various RAAM clinics throughout Grey and Bruce would set the Brightshores RAAM clinics apart from other RAAM clinics as this would be an additional offering through our clinics which is not common amongst other RAAM clinics in the province. Additionally, the closest Hepatitis C Team Network is in Kitchener, ON and the closest prescriber who clients are referred to is in London, therefore this program would contribute to bringing Hepatitis C screening, diagnosing, and treatment to a hyperlocal level. 

Student Involvement:

Role of the student: 

1. Obtain an understanding of the current RAAM clinic model and the nurse’s role within the model. 
2. Obtain an understanding of the link between IV drug use and Hepatitis C 
3. Gain an understanding of the screening criteria for Hepatitis C in Ontario and the nurse’s role within the screening process (obtaining phlebotomy, etc). 
4. Collaborate with current RAAM Nurses and Nurse Practitioner throughout the development of the program. Collaboration could be remote or onsite at the various RAAM locations. 
5. Develop the flow of the clinic to determine how Hepatitis C screening could be mended into the current RAAM model. 
6. Determine if Hepatitis C Screening would reasonably be able to occur at each RAAM clinic location taking into account the uniqueness of each clinic in the various regions of Grey/Bruce (Lions Head, Wiarton, Hanover, Meaford, Owen Sound, Durham, Kincardine, Port Elgin, Nawash). 
7. Determine what type of training would be needed for the current nurses/NP on the RAAM team. 
8. Determine how blood samples would be transported to the lab and which lab (Hospital or LifeLabs) or if the lab would pick up from a central location (Wellness and Recovery Centre). 
9. Consider which hospital policies/procedures would need to be developed/updated. 

Resources Required (if any):

• Hospital policies around nurses drawing blood 
• Hospital policies around NP’s drawing blood 
• Policies around transportation of blood products 
• Laboratory policies around drawing blood 

Support Offered to Students (i.e. weekly meetings, mentorship, etc.): To be determined, but the Nurse Practitioner and RAAM nurses may be able to meet weekly or bi-weekly.