Improving preconception care

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVE: To improve the documentation and delivery of preconception care to all women of reproductive age attending an inner city hospital's outpatient gynecology clinic. A secondary goal was to evaluate theknowledge and awareness ofproviders regarding preconception care. STUDY DESIGN: A prein-tervention chart review of a convenience sample of nonpregnant women with reproductive potential who attend an inner city hospital gynecology clinic (n = 100) was conducted to evaluate delivery of preconception care. Items screened for included: family planning services, domestic violence, nutrition and medical risk factors, medication use, appropriate counseling and use of referral services. All providers in the clinic were surveyed to assess their knowledge of and attitudes toward preconception care. A two-part intervention was then carried out: (1) a one-hour lecture for all providers, and (2) a standardized preconception care form inserted in all charts. A postintervention chart review of a second convenience sample (n = 100) and repeat provider survey were then conducted to evaluate the effectiveness of the two interventions. RESULTS: Following the two-pronged intervention, there was evidence of improved documentation of the delivery g preconception care. Documentation of screening in almost all categories was significantly improved (P < .05). The greatest improvements were noted in complete screening for medical risk factors (from 15% to 44%), for over-the-counter and prescription medication use (from 10% to 70% and 30% to 77%, respectively), domestic violence (from 10% to 57%) and nutrition (from 9% to 50%). However, provider knowledge of and attitudes toward preconception care were not significantly changed. CONCLUSION: The combination of education about preconception care and insertion of a standardized form into a patient's chart led to a clear improvement in the documentation of preconception care. Given the significance of preconception care, insertion of a standardized form should be considered to help providers deliver complete and appropriate care to their patients.

Original languageEnglish (US)
Pages (from-to)546-552
Number of pages7
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume45
Issue number7
StatePublished - 2000

Fingerprint

Preconception Care
Documentation
Domestic Violence
Urban Hospitals
Gynecology
Hospital Outpatient Clinics
Family Planning Services
Prescriptions
Counseling

Keywords

  • Fetus
  • Preconception care
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Improving preconception care. / Bernstein, Peter S.; Sanghvi, T.; Merkatz, Irwin R.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 45, No. 7, 2000, p. 546-552.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To improve the documentation and delivery of preconception care to all women of reproductive age attending an inner city hospital's outpatient gynecology clinic. A secondary goal was to evaluate theknowledge and awareness ofproviders regarding preconception care. STUDY DESIGN: A prein-tervention chart review of a convenience sample of nonpregnant women with reproductive potential who attend an inner city hospital gynecology clinic (n = 100) was conducted to evaluate delivery of preconception care. Items screened for included: family planning services, domestic violence, nutrition and medical risk factors, medication use, appropriate counseling and use of referral services. All providers in the clinic were surveyed to assess their knowledge of and attitudes toward preconception care. A two-part intervention was then carried out: (1) a one-hour lecture for all providers, and (2) a standardized preconception care form inserted in all charts. A postintervention chart review of a second convenience sample (n = 100) and repeat provider survey were then conducted to evaluate the effectiveness of the two interventions. RESULTS: Following the two-pronged intervention, there was evidence of improved documentation of the delivery g preconception care. Documentation of screening in almost all categories was significantly improved (P < .05). The greatest improvements were noted in complete screening for medical risk factors (from 15{\%} to 44{\%}), for over-the-counter and prescription medication use (from 10{\%} to 70{\%} and 30{\%} to 77{\%}, respectively), domestic violence (from 10{\%} to 57{\%}) and nutrition (from 9{\%} to 50{\%}). However, provider knowledge of and attitudes toward preconception care were not significantly changed. CONCLUSION: The combination of education about preconception care and insertion of a standardized form into a patient's chart led to a clear improvement in the documentation of preconception care. Given the significance of preconception care, insertion of a standardized form should be considered to help providers deliver complete and appropriate care to their patients.",
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