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Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics & gynecology Residency Websites between Two Consecutive Years

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Advances in Reproductive Sciences 2024年第1期12卷 14-22页

作者： Taylor Gatson Mark Alvarez Malik Mays Rachel Coleman Dani Zoorob School of Medicine Louisiana State University (LSU) Health Sciences Center Shreveport USA Department of Obstetrics and gynecology Louisiana State University (LSU) Health Sciences Center Shreveport USA College of Medicine and Life Sciences University of Toledo Toledo USA

Background: Few studies have focused on the geographic and chronologic assessment of inclusivity and wellness in Obstetrics and gynecology residency websites across the US. Objective: To identify variations in wellness and inclusivity website depictions across CREOG districts over the past two years. Methods: This is a cross-sectional analysis of the websites of ACGME-accredited OB/GYN residency programs across the United States between April 2022 and April 2023. The assessment was based on a compilation of 22 attributes devised and piloted by 49 medical students. A racially, geographically, and gender-diverse cohort of 11 students performed data collection. Results: A total of 560 websites were analyzed over two years. Wellness efforts remained unchanged in both years (website content, dedicated support personnel, and group activities). In 2023, a reduction in referencing of wellness (22%) and inclusivity (30%) occurred in leadership messaging. However, a 7% increase in the use of inclusive pronouns was noted. A reduction in gender diversity was identified (9% in faculty, 5% in residents), with programs favoring female-only teams. Similarly, a 7% reduction in the number of underrepresented in medicine faculty and residents was noted. A 15% reduction was noted in curricula referencing inclusivity in their mission statement and inclusivity focused research. Conclusions: This study suggests the variations across websites relative to inclusivity and wellness over the past two years. Updated websites may provide an accurate reflection of the offerings of programs and their investment in wellness and inclusivity across the nation.

关键词： Diversity gynecology Inclusion Obstetrics Residency

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Clinical application of multidisciplinary team-and evidence-based practice project in gynecological patients with perioperative hypothermia

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World Journal of Psychiatry 2023年第11期13卷 848-861页

作者： Qing-Yan Liu Tong-Yang You Dai-Ying Zhang Juan Wang The Operating Room The Affiliated Hospital of Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina

BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal co

关键词： Hypothermia gynecology Evidence-based care Knowledge translation Multidisciplinary team

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gynecology and Gynecological Nursing Theories and Practices in Traditional Chinese Medicine: Review on the Ancient Literatures

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Chinese Medicine 2011年第3期2卷 77-83页

作者： Xiangeng Zhang Hui Zhang Xiaoli Liang Qin Liu Miqu Wang 不详

Objective: the study is aimed to introduce the developing history of gynecology and gynecological nursing in traditional Chinese medicine (TCM). Study Design: the development of gynecology and gynecological nursing consists of six periods in Chinese history. They are: 1) budding stage represented by the inscriptions of Nü (female) on oracle bones;2) physiological development stages of women;3) specialized chapters of gynecology in TCM;4) features of gynecological nursing;5) monograph of gynecology and gynecological nursing;6) integration of ancient gynecological nursing perceptions. Results: TCM has a profound understanding of gynecology and gynecological nursing. For period one, the inscriptions of Nü (female) on oracle bones is the symbol of the budding stage. For period two, physiogenesis stages of women are recorded in The Yellow Emperor of Classics of Inner Medicine. For period three, the specialized chapters of gynecology appeared, represented by Golden Chamber, Woman. For period four, the features of gynecological nursing were elaborated in Essential Prescriptions Worth A Thousand Gold including menstruation, depression, yin-dampness, and menopause. For period five, monographs of gynecology and gynecological nursing represented by Good Comprehensive Woman Formulae appeared. For period six, Integrative studies of gynecological nursing perceptions were carried out with the representation by Integrated Ancient and Modern Books. Conclusion: TCM gynecology and gynecological nursing harbors a long history of treating and nursing gynecological disorders. With therapeutic and nursing modalities, they are effective systems of un-derstanding and managing woman health as proven by medical literatures, clinical benefits and basic research studies.

关键词： TCM gynecology TCM Gynecological Nursing Traditional Chinese Medicine (TCM)

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Intra-Hospital Delay in Emergency Care at the Obstetrics and gynecology Department in the University Teaching Hospital of Ouagadougou(UTH-YO),Burkina Faso

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Open Journal of Obstetrics and gynecology 2017年第12期7卷 1151-1159页

作者： Ouattara Adama Tougma Aline Pegwendé Yaméogo Relwendé Barnabé Millogo/Traoré Francoise Danielle Ouedraogo Issa Kiemtoré Sibraogo Ouédraogo Ali Thieba/Bonane Blandine The University Teaching Hospital of Ouagadougou OuagadougouBurkina Faso The regional Hospital of Ouahigouya OuahigouyaBurkina Faso

Objective: To investigate the intra-hospital delay in the treatment of gynecological and obstetric emergencies in the obstetrics and gynecology department at the UTH-YO. Patients and methods: It has been a prospective and descriptive study over a period of four months from 1 May to 31 August 2015 in the obstetrics and gynecology department at the UTH-YO. All patients and their escorts were included in our study, admitted to gynecological or obstetric emergencies who have accepted to participate in the survey. Data were entered and analyzed using a PC equipped with the SPSS 16.0 software English version. Results: During the study period, we recorded 2627 admissions. Delays in the management involved 216 patients or a frequency of 8.2%. The average age of patients was 26.6 ± 6.2 years, ranging from 16 and 46 years. Patients had no income in 165 cases (that is to say 76.4%). The referred patients accounted for 165 admissions (85.7%). The intake patterns were dominated by obstetric acute fetal distress in 44 cases (20.4%), pre-failure syndrome in 27 cases (that is to say 12.8%) and in gynecology by the ectopic pregnancy in 171 cases (79.3%). The average waiting period between the arrival of a patient and the beginning of first aid was 2 hours and 23 minutes with extremes of 16 min and 546 min. The main reason for the delay was the unavailability of the operating room in 61.1% of cases. The opinion of escorts was dominated by improving communication with the creation of a post of information in 47% of cases. Maternal prognosis was marked by a maternal death in 0.1% of cases and maternal morbidity in 13.4% of cases. The fetal prognosis was dominated by death at birth in 13.8% of newborns. Conclusion: Despite the subsidy of the government in obstetric and neonatal emergencies, there remain intra-hospital delays in the management of emergencies. The opening of discussions between the various stakeholders responsible for the implementation of this grant is urgent to contribute more effectively to the fight against materna

关键词： Delay Emergency Obstetrics gynecology Ouagadougou

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Lean Management in Obstetrics and gynecology: Application in the Ambulatory Clinic Pre- and Post-Kaizen

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Open Journal of Obstetrics and gynecology 2018年第14期8卷 1604-1630页

作者： Michele Follen Leo Fradkin Joseph Crane Chuck Noon Kings County Hospital Clarkson Brooklyn NY USA University of Tennessee Haslam College of Business Knoxville TN USA Brookdale Hospital and Medcial Center One Brookdale Plaza Brooklyn NY USA Teamhealth INC Knoxville TN USA

OBJECTIVE: The ambulatory clinic was an important departmental problem. Providers hated working there and patients complained about the wait times there. It seemed there were equal numbers of patients and provider complaints. In the spirit of solving the problem, data was gathered, a LEAN intervention was planned, and data was collected. METHODS: We defined the service families in the clinic as registration, vital signs, provider or ultrasound visit, nursing visit, and registration for the return visit. We walked the Gemba engaging all the staff in the process. Many observations pointed to long waits between and among the five stations. In order to study the current state, time data was collected by attaching a sheet of paper to a folder that the patient would carry themselves to all the clinical steps. On the sheet of paper each station logged the time that patient appeared and the time the patient left their sight. Data was gathered each day and every day from October 2016 to the summer of 2017. The data was analyzed. Leadership met and identified value and waste in the process. A Kaizen event was scheduled after the first set of measurements engaging all the staff. After the data was thoroughly analyzed and digested, brainstorming occurred. Together we determined our future state. We created a vision and strategic goals to reach our future state. RESULTS: The data pre-Kaizen event showed that the process of arrival to leaving took 124 minutes. We discovered that not every patient passed through each station. We learned the patients were on time or early for their visit most of the time. The providers were late most of the time by 1 - 1.5 hours. We learned how long each station took from the patient’s point of view. There were no statistically significant differences between ultrasound and provider visits;there were no statistically significant differences between midwife and physician visits. Each day of the week was similar. The arrival rate was higher in the morning because of the template. After the event,

关键词： Lean Management Healthcare LEAN and Obstetrics and gynecology Lean and Ambulatory Care Lean and Women’s Health

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Retrospective Cohort Study on Acute Care in Obstetrics and gynecology: Analogies and Differences When Compared to Emergency Medicine

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Open Journal of Obstetrics and gynecology 2017年第4期7卷 473-485页

作者： Giuseppe Chiossi Stefano Palomba Sara Balduzzi Maged M. Costantine Angela I. Falbo Anna M. Ferrari Giovanni B. La Sala Department of Obstetrics and gynecology University of Texas Medical Branch Galveston TX USA Department of Obstetrics and gynecology Arcispedale Santa Maria Nuova IRCCS Reggio Emilia Italy Statistics Unit Department of Oncology Hematology and Respiratory Diseases University of Modena and Reggio Emilia Modena Italy Department of Emergency Medicine Arcispedale Santa Maria Nuova IRCCS Reggio Emilia Italy University of Modena and Reggio Emilia via Università 4 Modena Italy

Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients’ health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks’ gestation, OR: 30.7, 95%CI;24.5 - 38.4;>12 weeks’ gestation, OR 81.2, 95%CI;64.8 - 101.4), vaginal bleeding (OR 156.6, 95%CI;82.7 - 294.4), diurnal (night access OR 0.87, 95% CI;0.78 - 0.96) and weekday access (holiday access OR 0.87, 95%CI;0.78 - 0.95), frequent users (recurrent ED visits IRR 0.87, 95%CI;0.83 - 0.9) and lower hospital admissions (ED admission OR 1.6, 95%CI;1.4 - 1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of “crowding”. Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.

关键词： Acute Care Obstetric Urgencies Gynecologic Urgencies Obstetrics and gynecology Triage Emergency Department

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Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

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Health 2014年第2期6卷 158-164页

作者： Abubaker Ibrahim Elbur M. A. Yousif Ahmed S. A. El Sayed Manar E. Abdel-Rahman Department of Cardiothoracic Surgery Al-Shaab Teaching Hospital Khartoum Sudan Faculty of Mathematical Sciences University of Khartoum Khartoum Sudan Faculty of Pharmacy Gezira University Wad Madani Sudan Pharmacy Practice Research Unit (PPRU) College of Pharmacy Taif University Taif KSA Pharmacy Practice Research Unit (PPRU) College of Pharmacy Taif University Taif KSA

Purpose: This study was conducted to audit prophylactic antibiotic use and to quantify the rate of wound infection. Methods: Across-sectional prospective study was conducted in the Obstetrics and gynecology Department in Khartoum Teaching Hospital, Sudan during March 1st to 31st October 2010. All Patients (aged >18 years) were included. Results: Overall 725 patients were included. The performed surgical procedures were 751;of these 578 (76.9%) were Caesarean sections. Overall rate of wound infection was 7.8%. The rate of wound infection among patients operated on for caesarean section and abdominal hysterectomy was 8.3%, and 9.2%, respectively. Multivariate logistic analysis showed that body mass index [BMI] ≥ 30 kg/m2 OR 2.1, 95% CI (1.1 - 4.0), (P = 0.019) was the major independent risk factor for occurrence of wound infection. Evaluation of prescriptions’ parameters against the stated criteria showed that 113 (15.8%) patients were given antibiotics with adequate spectrum of activity, 611 (85.3%) given sub-dose/s, 83 (11.6%) received the first preoperative dose/s in a proper time window, and 716 (100%) had prophylaxis for extended duration. Overall conformity to the stated criteria for the evaluation of prescription’s parameters was not achieved in all prescriptions. Conclusions: In this setting, antibiotics were irrationally used and wound infection rate was high, and the situation calls for multiple interventions to correct the situation, through the activation of the infection control committee in the hospital and development of antimicrobial subcommittee to develop policies for the use and auditing of prophylactic antibiotics.

关键词： Prophylactic Antibiotics Wound Infection Obstetrics and gynecology Sudan

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Application of Serum Ferritin Combined with Blood Routine Testing in the Screening of Obstetrics and gynecology Diseases

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Advances in Reproductive Sciences 2021年第2期9卷 118-128页

作者： Yueliao Ma Zhiyong Qin Chundong Qiu Xiaohua Huang Laboratory Department of Maternal and Child Health Hospital Hechi China Inspection Department of Guiping People’s Hospital Guigang China First People’s Hospital of Yulin Yulin China Department of Traditional Chinese Medicine of Yunyang County Chongqing China

Objective: To understand the application of serum ferritin combined with blood routine testing in the screening of obstetrics and gynecology diseases in this region. Methods: From January 1, 2017, to October 28, 2020, all obstetric pregnant women, inpatient maternal, gynecological outpatient, and gynecological inpatients in our hospital’s outpatient and inpatient clinics were collected for serum ferritin determination and blood routine related index detection and analysis Changes in results. The application value of serum special protein in gynecological and obstetrical disease screening was put forward. Results: A total of 15,656 cases of obstetrics and gynecology patients were collected, of which 15,300 were pregnant women. Comparing maternity checkups with hospitalized puerpera, the difference of all indexes except RBC was statistically significant (P 0.05). Comparison of hospitalized puerpera and gynecological hospitalization, the difference of other indexes except for MCV, MCH was statistically significant (P 0.05). Conclusion: During the maternity check-up period, the ferritin consumption is too large, the blood volume increases, a

关键词： Ferritin Pregnant Women Obstetrics gynecology Disease Screening

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Clinical view of gynecologic intraoperative frozen section diagnosis

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gynecology and Obstetrics Clinical Medicine 2022年第1期2卷 6-8页

作者： Alexander B.Olawaiye Chengquan Zhao Deporoment of Obsteprics and Gynecolagy Universiy of Piusbugh Medical CenterPinsburghPA16066USA Deparoment of Patholgy Uriversity of Piusbugh Medical CenterPitsbughPA16066USA

Intraoperative consultation includes gross evaluation and frozen section,whitch is an integral component of surgical oncology for many reasons.First,it allows appropriate surgical procedures to be undertaken.Second,it can potentially protect the patient from a second procedure.Thitd,it helps towards counselling of paients and their family members and lasty,it faclilitates early management planning.Udlizaion of frozen section is justified by the reported sensi dvity,specificity,positive and negativwe predictive values all of which are as high as 90-100%in some studies.It is very impor tant for gynecologists to have good communication with pathologi sts,especially for cass with an indeterminate,frozen result.Discussion with the pathologist can help the gynecologist understand the diagnostic dilemma and the differential diagnosis,which can help them make best surgical decisions.

关键词： gynecology Intraoperative Pathology

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Routine abortion training matters for obstetrics and gynecology residents

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Open Journal of Obstetrics and gynecology 2013年第10期3卷 727-731页

作者： Sahnah Lim Corey Westover Rini B. Ratan Maryam Guiahi Department of Obstetrics and gynecology Columbia University New York USA Department of Obstetrics and gynecology University of Colorado Anshutz Aurora USA John Hopkins School of Public Health Baltimore USA

Background: We set out to compare resident perspective regarding self-rated ability to perform abortion procedures, abortion attitudes and satisfaction with training at programs with routine and optional abortion training. Methods: We distributed surveys and conducted 1-h focus groups for 62 residents at six New York City OB/GYN programs;three offer routine abortion training. We compared resident survey responses at programs with routine versus optional training regarding self-rated ability to perform abortion procedures, abortion attitudes and satisfaction with training. We reviewed focus group transcripts to understand differences related to satisfaction with abortion training. Results: Residents at routine programs reported higher proportions of self-rated ability to perform abortion procedures (all surveyed procedures p ≤ 0.05) and were more likely to fully participate in abortion services than residents at optional programs (42/45 vs. 12/17, p = 0.03). Residents at routine programs were more likely to be “very satisfied” with training (44/45 vs. 12/17, p < 0.001) based on three aspects of training: patient care management, self-rated ability to perform abortion procedures and rotation characteristics. Conclusion: Residents who received routine abortion training have higher rates of self-reported procedural competency and are more likely to be satisfied with training than residents who were offered optional training.

关键词： Family Planning Abortion Training Obstetrics and gynecology

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