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Increased adherence to prenatal group B streptococcal screening guidelines through a paired electronic reminder and education intervention.

Abstract：

:The 2010 Centers for Disease Control and Prevention (CDC) update on perinatal group B streptococcal (GBS) prevention advises universal vaginal-rectal GBS screening of pregnant women in the 35th through 37th week of gestation. Because GBS colonization is transient, a test performed more than 5 weeks before delivery may not have sufficient negative predictive value to be clinically useful. Our objective was to increase rates of quality-improved, CDC-adherent GBS screening and decrease repeat screening. A reminder for maternal vaginal-rectal GBS testing was added to the physicians' electronic ordering screen, and family medicine physicians and residents were educated about screening guidelines through standardized, in-person presentations. Retrospective chart review was performed before and after these interventions. Univariate or bivariate analysis was performed for demographic factors, timing of first screen, rates of CDC-adherent screening (the newly defined quality-improved screen and the usual screen), and rates of repeat and unnecessary screens. Multivariate analysis was performed with quality-improved and usual screening as dependent variables. Bivariate analysis showed that post-intervention rates of quality-improved screening increased from 30 to 62 % (P < .001), usual screening increased from 69 to 84 % (P = .005), and repeat GBS screening decreased from 20 to 8 % (P = .007). Multivariate analysis showed increased post-intervention odds of quality-improved screening [odds ratio (OR) 3.59; 95 % CI 2.07-6.34] and usual screening (OR 2.67; 95 % CI 1.40-5.25). Low-cost, reproducible quality improvement interventions (electronic order reminder, educational sessions) have the potential to increase guideline adherence for GBS screening in pregnant women and decrease repeat screening.

journal_name

Matern Child Health J

journal_title

Maternal and child health journal

authors

MacLaughlin KL,Garrison GM,Matthews MR,O'Brien ML,Westby E,Targonski PV

doi

10.1007/s10995-013-1228-7

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

16-21

issue

eissn

1092-7875

issn

1573-6628

pii

10.1007/s10995-013-1228-7

journal_volume

pub_type

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Increased adherence to prenatal group B streptococcal screening guidelines through a paired electronic reminder and education intervention.