{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:27:14Z","timestamp":1730870834037,"version":"3.28.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"name":"Oregon Health Authority Grant","award":["#160910"],"award-info":[{"award-number":["#160910"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003To develop and implement a Group B Streptococcal (GBS) dynamic order set to improve adherence to the American College of Obstetricians and Gynecologists\/Centers for Disease Control and Prevention (ACOG\/CDC) guidelines.<\/jats:p><jats:p>\n            Study Design\u2003A team of information technology and clinical experts developed a dynamic order block. The content was patterned after the CDC \u201cPrevent GBS\u201d mobile app. It was then embedded in the labor and delivery\/induction order set and piloted at a single high-volume obstetric unit. Following the pilot and incorporation of the 2019 ACOG update of the CDC guidelines, the order set was rolled out in five additional hospitals within a region of a large health system. Information on GBS prophylaxis performance before and after implementation was available for the pilot site and four of the additional hospitals. Information before implementation was obtained electronically from electronic medical record (EMR) laboratory and pharmacy data and supplemented by manual chart review. Postimplementation data were obtained from discrete order set EMR data elements. Adherence to the guidelines before and after were compared using chi-squared test.<\/jats:p><jats:p>\n            Results\u2003There were 7,114 deliveries before implementation and 4,502 after implementation. Preterm delivery occurred in 6.8 and 6.9%, respectively. There was an increase in appropriate treatment of preterm patients (positive and unknown GBS) delivering after implementation (88.7\u201399.1%, p\u2009&lt;\u20090.001). More patients were reported to have a penicillin allergy before implementation than after implementation (14.7 vs. 11.1%, respectively, p\u2009=\u20090.01). Associated changes in therapy noted after implementation included a nonsignificant decrease in the proportion reporting a high-risk allergy (50.3 vs. 41.9%, p\u2009=\u20090.18), an increase in the appropriate use of clindamycin and vancomycin (64.4 vs. 92.3%, p\u2009&lt;\u20090.001) and a decrease in clindamycin use in those without sensitivity testing.<\/jats:p><jats:p>\n            Conclusion\u2003Routine universal use of a dynamic admission labor\/induction order set was associated with high and improved adherence to GBS prophylaxis guidelines.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2196-6078","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T23:14:02Z","timestamp":1698102842000},"page":"e3124-e3132","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Maternal Group B Streptococcus Prophylaxis Improvement using an Electronic Medical Record Dynamic Order Set"],"prefix":"10.1055","volume":"41","author":[{"given":"Mark W.","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Providence Women's and Children's Program, Providence Health and Services, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael","family":"Baker","sequence":"additional","affiliation":[{"name":"Providence Women's and Children's Program, Providence Health and Services, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Ulrich","sequence":"additional","affiliation":[{"name":"Providence Clinical Informatics, Providence Health and Services, Renton, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maulin","family":"Shah","sequence":"additional","affiliation":[{"name":"Providence Clinical Informatics, Providence Health and Services, Renton, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horia","family":"Marginean","sequence":"additional","affiliation":[{"name":"Providence Brain and Spine Institute, Providence Health and Services, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Girolami","sequence":"additional","affiliation":[{"name":"Providence Clinical Informatics, Providence Health and Services, Renton, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"ref1","first-page":"e19","article-title":"ACOG Committee Opinion #782. Prevention of group B streptococcal early-onset disease in newborns","volume":"134","author":"American College of Obstetricians and Gynecologists","year":"2019","journal-title":"Obstet Gynecol"},{"key":"ref2","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease\u2013revised guidelines from CDC, 2010","volume":"59","author":"J R Verani","year":"2010","journal-title":"MMWR Recomm Rep"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1001\/jamapediatrics.2018.4826","article-title":"Epidemiology of invasive early-onset and late-onset group B streptococcal disease in the United States, 2006\u20132015","volume":"173","author":"S A Nanduri","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1097\/AOG.0000000000000163","article-title":"Early-onset group B streptococcal disease in the United States: potential for further reduction","volume":"123","author":"J R Verani","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1097\/AOG.0000000000001297","article-title":"Use of cefazolin for group B streptococci prophylaxis in women reporting a penicillin allergy without anaphylaxis","volume":"127","author":"V A Briody","year":"2016","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"150.e1","DOI":"10.1016\/j.ajog.2010.08.063","article-title":"Group B streptococcus prophylaxis in patients who report a penicillin allergy: a follow-up study","volume":"204","author":"A S Critchfield","year":"2011","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"ref7","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1136\/bmjqs-2015-004411","article-title":"SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process","volume":"25","author":"G Ogrinc","year":"2016","journal-title":"BMJ Qual Saf"},{"issue":"24","key":"ref8","doi-asserted-by":"crossref","first-page":"2338","DOI":"10.1056\/NEJMra1807761","article-title":"Penicillin allergy","volume":"381","author":"M Castells","year":"2019","journal-title":"N Engl J Med"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1001\/jama.2018.19283","article-title":"Evaluation and management of penicillin allergy; a review","volume":"321","author":"E S Shenoy","year":"2019","journal-title":"JAMA"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/AOG.0000000000004213","article-title":"Outpatient penicillin allergy testing in pregnant women who report an allergy","volume":"137","author":"N Desravines","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"100674","DOI":"10.1016\/j.ajogmf.2022.100674","article-title":"Outpatient penicillin allergy evaluation during pregnancy and associated clinical outcomes","volume":"4","author":"J H Kwah","year":"2022","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/S1081-1206(10)60007-5","article-title":"Penicillin skin testing in pregnant women with a history of penicillin allergy and group B streptococcus colonization","volume":"97","author":"E Macy","year":"2006","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"06","key":"ref13","first-page":"480","article-title":"Management of group B streptococcus in pregnant women with penicillin allergy","volume":"52","author":"E H Philipson","year":"2007","journal-title":"J Reprod Med"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1055\/s-0039-3401801","article-title":"Time has come for routine penicillin allergy testing in obstetrics","volume":"10","author":"E Cook","year":"2020","journal-title":"AJP Rep"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/AOG.0000000000001800","article-title":"Streptococci screening before repeat cesarean delivery","volume":"129","author":"C M Albright","year":"2017","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2196-6078.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:47:26Z","timestamp":1730814446000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2196-6078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,23]]},"references-count":15,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2196-6078","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2023,10,23]]},"published":{"date-parts":[[2023,10,23]]}}}