BACKGROUND:
The Pennsylvania Department of Health, Divison of Immunizations initiated an educational mailing on the updates to the Perinatal Hepatitis B Prevention Program for all licensed acute care hospitals in the state.

OBJECTIVE:
The goal of the attached algorithm was to offer a quick reference for labor and delivery nurses to determine maternal hepatitis B surface antigen status and to provide the recommended treatment protocols to their high-risk infants.

METHOD:
In December of 2002, the updated protocols for the Perinatal Hepatitis B Prevention Program in Pennsylvania were mailed to all acute care hospitals. Included in the updated protocols were endosements from the PA Physician General, the Presidents of the PA Chapter of the AAP, AAFP, ACOG, and the Pennsylvania Medical Society along with the 2002 regulation requiring HBsAg testing for all pregnant women and the need for "the appropriate prophylactic treatment of the newborn." In an effort to provide nursing and medical staff with a quick reference for these treatment protocols, a flow chart outlining steps to be taken by labor and delivery and/or emergency department staff was developed and added to the hospital mailing. The flow chart resembles many algorithms used in the acute care setting for medical conditions and therefore is a recognizable format for health care providers to utilize.

RESULT:
The Division of Immunizations has only been informed of one deliverying woman that did not have a reliable HBsAg test result on her chart when admitted to the hospital Labor and Delivery Unit and the hospital did not obtain the results or order the necessary lab work to assess the newborn's HBsAg perinatal trasmission risk prior to discharge.

CONCLUSION:
Complex treatment protocols can be formatted and easily referenced in busy acute care settings to assist with management of delivering womenb and their HBsAg status.

LEARNING OBJECTIVES:
To share approved testing and treatmentn protocols for high-risk perinatal hepatitis B newborns in an effort to reduce perinatal hepatitis B transmission.