Date of Publication


Project Team

Rebecca Yukica, DO


Purpose: There is a high risk of tick-borne diseases in the summer camp environment. Rapid nursing assessment is essential in identifying camper risk and for the provision of prophylactic antibiotics. The project objectives are to (1) modify the existing evidence-based standing orders for the provision of post-tick exposure prophylactic antibiotics, (2) provide summer camp nurse education, and (3) propose implementation strategies.

Methods: Nurses from fourteen summer camps contracting services from a Northeast pediatric primary care office completed a needs assessment regarding barriers to tick exposure assessment and independent utilization of an existing evidence-based protocol. The existing protocol was revised to include a rapid assessment tool for identification of campers at risk. The updated protocol and educational PowerPoint were disseminated to camp nurses, and feedback collected.

Results: Fifteen nurses completed the needs assessment. Eighty percent (n=12) were not confident with tick assessment skills and 67% (n=10) were not confident independently initiating post-tick exposure prophylaxis. Perceived barriers included inability to identify tick species (n=4) and determine scutal index (n=7), and discomfort with independent initiation of prophylaxis (n=7). Following protocol education, 100% (n=15) of nurses reported increased confidence in tick exposure assessment skills and confidence independently initiating post-tick exposure prophylaxis.

Conclusions: An evidence-based practice protocol addressed knowledge gaps and barriers. Revised protocol will be included in the nurse pre-camp medical orientation. Tick identification skills will need to be verified. Future research includes evaluation of protocol utilization and incidence of tick-borne disease at summer camps.

Document Type


Available for download on Wednesday, May 04, 2022