Learning Objectives for this Presentation:
By the end of the presentation participants will be able to identify 3 factors associated with proper Hepatitis B screening practices and 3 factors associated with proper Hepatitis B vaccination.

Background:
The Indiana Perinatal Hepatitis B (PHB) program is responsible for investigating reported cases of pregnant women diagnosed with Hepatitis B infection. The responsibility includes: that the newborn receives HBIG, completes Hepatitis B vaccine series (including birth dose), and is tested for serologic immunity. The program works with physicians to screen all pregnant women for Hepatitis B infection, and with hospitals to implement a universal Hepatitis B vaccine birth dose policy.

Objectives:
To determine if/how HBsAg screening was performed and to determine hospital practices regarding administration of the hepatitis B vaccine to newborns prior to discharge.

Methods:
Interviews with labor and delivery nurse managers were completed. Hospital labor and delivery charts from the first 6 months of 2004 were assessed. No individual identifying information was collected. A standardized survey form was used to collect data, including healthcare coverage, Hepatitis B testing, and vaccination. Data on HBsAg testing in pregnant women and birth dose administration was compared among 13 Indiana hospitals.

Results:
Results indicate that 96.1% of pregnant women were tested for Hepatitis B; however only 39.7% were tested in the first trimester; 89.9% of the results were transcribed. Only 69.4% of the newborns received the birth dose of Hepatitis B vaccine and only 13% had proper VIS documentation. 81.7% had maternal Hepatitis B status recorded in the newborn charts.

Conclusions:
Results from these 13 hospital assessments were presented to the hospitals to help improve practices. One hospital implemented a universal birth dose strategy and 3 hospitals enrolled in the VFC program. Two physician groups implemented Hepatitis B re-screening of mothers with risk factors.