Patient Readiness for Surgery: A Quality Improvement Initiative.

The use of a surgical safety checklist can help prevent sentinel events; however, a lack of adherence to the checklist can result in inadequate preoperative patient readiness and negative outcomes. The purpose of this quality improvement project was to address preoperative concerns that prevent patient readiness in a military hospital. To change practice, the project involved the use of an evidence-based practice model and Kurt Lewin's change theory.

Perceptions to Overcoming Barriers to Prenatal Care in African American Women.

Pregnancy-related deaths affect African American women at a rate four to five times higher than White women. These deaths occur during pregnancy or up to 1 year after childbirth. Inadequate or delayed prenatal care is a factor associated with poor maternal health outcomes in African American women.

The Effect of Implementing a Standardized Enhanced Recovery After Surgery Pain Management Pathway at an Urban Medical Center in Hawaii.

Traditional use of opioids to treat postoperative pain may lead to abuse and overdose. The development of Enhanced Recovery After Surgery (ERAS) protocols has helped to shift pain management from traditional methods to evidence-based best practices involving multimodal analgesia techniques. The purpose of this quality improvement project was to implement and determine the effectiveness of a standardized, evidence-based ERAS pain management pathway for patients undergoing colorectal or gynecology procedures at a medical center in Hawaii.

Evaluation of a pre-exposure prophylaxis (PrEP) program for HIV prevention in a federally qualified health center (FQHC).

Background: Preventing new cases of the human immunodeficiency virus (HIV) is key to the Centers for Disease Control and Prevention (CDC) Ending the HIV Epidemic: A Plan for America initiative. In 2012, Truvada became the first medication approved in the United States to prevent HIV infection, yet it has not seen widespread use.

Aim: This study aimed to allow for the incorporation of an HIV risk assessment into the primary care provider (PCP) visit and promote increased numbers of patients screened for pre-exposure prophylaxis of HIV (PrEP).

Improving Attitudes and Beliefs of Cervical Cancer Screening Guidelines: An Evidence-Based Quality Improvement Project.

Cervical cancer, one of the most common gynecological cancers in the United States, is highly preventable due to the papanicoloau (Pap) test with human papillomavirus (HPV) co-screening. However, there is increasing evidence of low adherence to screening guidelines by health care providers (HCP). The purpose of this study was to identify and improve health care providers' attitudes, beliefs, and knowledge of the most updated screening guidelines and to provide them with an evidence-based educational intervention to increase their confidence in the updated guidelines, improve their attitudes and beliefs, and screen their patients more appropriately.

Brain Science-Based Innovative Collaborative Teaching to Facilitate Nursing Education.

Background: Innovative teaching that effectively promotes learning is a process called brain science. Chemicals released during motivation and attention lead to improved learning, and chemicals released during high-stress situations deter learning. The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented stress while providing an opportunity to create innovative strategies for facilitated learning.

The Role of Vitamin B6 in Women's Health.

Vitamin B6, a cofactor in many biochemical reactions in the cells of living organisms, is an essential coenzyme for various catabolic and anabolic processes. Although vitamin B6 deficiency in young healthy women with a balanced diet is thought to be unusual, it can be seen with certain medications, health conditions, and dietary deficits, as well as aging. Vitamin B6 deficiency is associated with a variety of ill health effects, and correction of deficiency is considered beneficial.

The Stigma of Sexually Transmitted Infections.

Evidence-based guidelines have improved diagnosis and treatment of sexually transmitted infections (STI). Social stigma remains a barrier to STI testing and is associated with underutilization of prevention services. Alternatives for STI testing (eg, in-home testing) are convenient.

Integration of a Comprehensive Contraception Education Program Into Clinical Practice in a Family Planning Clinic.

Objective: To improve rates of contraception adherence by implementing a comprehensive contraception educational program for women receiving care at a family planning clinic.

Design: Quasi-experimental cohort study in which we evaluated women presenting before (control group) and after program implementation (intervention group) and compared the proportion of women returning for contraceptive method change and/or for unintended pregnancy.

Setting: Family planning clinic of a large academic medical center.

Conversion to Chlorhexidine Gluconate for Perioperative Vaginal Preparation: An Evidence-Based Process Improvement Project.

Surgical site infections (SSIs) occur during the postoperative period and involve the operative site. To lower the occurrence of SSIs in their patient population, the gynecology SSI prevention committee at a large academic medical institution initiated a process improvement project examining vaginal antiseptic skin prep solutions. Some studies indicate that chlorhexidine gluconate (CHG) is superior to povidone-iodine in the reduction of microbial skin counts and SSIs.

Improving Provider Readiness for Intimate Partner Violence Screening.

Background: Intimate partner violence (IPV) is a significant public health issue. Healthcare providers (e.g.

Management of first-trimester complications in the emergency department.

Purpose: The pharmacologic management and the nonpharmacologic management of first-trimester complications in the emergency department are reviewed.

Summary: The obstetric complications most commonly seen in early pregnancy (less than 20 weeks' gestation) include ectopic pregnancy, threatened and inevitable abortions, and incomplete, complete, and missed abortions. The treatment options for ectopic pregnancy include expectant management, medical management with methotrexate, and surgery.

The effect of gynecologic algorithm pathways on emergency department visit times.

Background: The use of multidisciplinary algorithmic pathways is one strategy to improve efficiency and quality of care in Emergency Departments (EDs). To this end, in the fall of 2005, we implemented algorithmic pathways for evaluation of ED patients with common gynecologic complaints.

Objectives: The goals of this initiative were to improve length of stay as a marker for operational efficiency and to reduce health care disparities by ensuring consistent management regimens for all patients.