Interprofessional Education Between Midwifery Students and Obstetrics and Gynecology Residents: An American College of Nurse-Midwives and American College of Obstetricians and Gynecologists Collaboration.

Despite areas of excellence, US perinatal care outcomes lag behind most developed countries. In addition, a shortage and maldistribution of health care providers exists. The American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists (ACOG) partnered to obtain funding to develop interprofessional education modules and other learning activities for midwifery students and obstetrics and gynecology residents in 4 demonstration sites. The multidisciplinary 2016 ACOG document Collaboration in Practice: Implementing Team-Based Care was adopted as a framework. Core competencies of values and ethics, roles and responsibilities, interprofessional communication, and teams and teamwork developed by the Interprofessional Education Collaborative were used to guide the work. Seven modules have been developed including guiding principles, patient-centered care, role clarification, collaborative practice, history and culture, care transition, and difficult conversations. Learners participate in laboratory and simulation activities and work together in clinical care settings. Stakeholder experiences as well as barriers to implementation are discussed. Learning materials and activity descriptions are open resourced and shared on a project website for use by programs interested in implementing an interprofessional curriculum. Ongoing formal evaluation including pilot testing of a program evaluation method is described.

Outcomes of effective transmission of electronic prenatal records from the office to the hospital.

OBJECTIVE: To investigate the outcomes associated with improved transmission of prenatal test results between the outpatient and inpatient obstetric setting after implementation of an electronic prenatal record system. METHODS: Admission paper charts of patients admitted to our labor and delivery unit were reviewed before and after implementation of an electronic prenatal record system. The availability of maternal hepatitis B and human immunodeficiency virus (HIV) serology on admission, the occurrence of repeat hepatitis B surface antigen and rapid HIV blood testing, and the occurrence of hepatitis B immunoglobulin administration to the newborns of mothers without available hepatitis B serology was recorded. Fisher's exact tests were performed to determine differences in availability of prenatal test results, the occurrence of repeat blood testing, and the occurrence of immunoglobulin administration before and after implementation. RESULTS: A total of 460 admission charts were reviewed, 229 preimplementation and 231 postimplementation. Of the preimplementation charts, 78.2% contained maternal hepatitis B and HIV serology results, whereas all postimplementation charts contained such results (P<.001). Although repeat hepatitis B surface antigen testing was performed in 3.1% of patients preimplementation, no patients required repeat testing postimplementation (P=.007). Similarly, rapid HIV blood testing was performed in 3.5% of patients preimplementation, but no patients required repeat testing postimplementation (P=.003). Increased availability of testing results prevented unnecessary administration of hepatitis B immunoglobulin postimplementation. CONCLUSION: Implementation of an electronic perinatal record system was associated with improved transmission of prenatal test results between the outpatient and inpatient obstetric setting and a decreased rate of unnecessary maternal testing and newborn interventions. LEVEL OF EVIDENCE: III.

Sacral nerve stimulation during pregnancy: case report and review of the literature.

BACKGROUND: The use of sacral nerve stimulation during pregnancy is not recommended because of the unknown effects on the offspring. There is a paucity of literature on the subject. CASE: A 25-year-old woman who had a sacral nerve stimulator for severe interstitial cystitis/bladder pain syndrome had 2 successful pregnancies. Against medical advice, she kept the stimulator activated for symptom control during the pregnancies. The first child was later diagnosed with chronic motor tic disorder, and the second had a pilonidal sinus at birth. Whether this outcome is related to the neurostimulator is unknown. The efficacy of sacral nerve stimulation decreased after each pregnancy. CONCLUSION: The safety of sacral nerve stimulation in pregnancy has not been well established. Until further research is done, we recommend that women of reproductive age with a sacral nerve stimulator be advised about contraception and that the device should be deactivated before or as soon as pregnancy is confirmed.

Transdisciplinary teamwork simulation in obstetrics-gynecology health care education.

This program evaluation was designed to assess whether a transdisciplinary teamwork simulation experience improves collaborative attitudes among women's health students toward the goals of reducing medical errors and improving patient outcomes. This program evaluation used a pretest-posttest comparative design to measure changes in collaborative attitudes among 35 multidisciplinary women's health students before and after a transdisciplinary simulation experience. Collaborative attitudes were measured by the Team Attitudes Questionnaire. Data analysis consisted of descriptive analysis, paired t tests, and post hoc item analysis. Findings suggest significant increases in collaborative attitudes for mutual support and communication but no significant increases in attitudes for structure, situation monitoring, or leadership from pretest to posttest. Trans-disciplinary simulation experiences among women's health students may enhance mutual support and communication and promote better patient outcomes. Future research should focus on mechanisms to facilitate improvements in structure, situation monitoring, and leadership.

Self-disclosure of sexually transmitted diseases: an integrative review.

In the United States, there are currently more than 65 million individuals living with a sexually transmitted disease (STD), and approximately 19 million new infections will continue to occur each year. To decrease the transmission of potentially dangerous and life-altering STDs, self-disclosure of sexual and drug history and sexual orientation is paramount. This integrative review examines the concept of self-disclosure of STDs, suggests areas of additional research, and proposes a comprehensive public health campaign, with a specific focus on the recent human papillomavirus epidemic to improve the physical and psychological health of all individuals.