Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe how the Chicago Department of Public Health (CDPH) used chart audit results in an intervention to assess and improve hepatitis B prevention practices in birthing hospitals.

Background:
In Chicago, over 200 infants are born to hepatitis B positive women each year. Administering HBIG and hepatitis B vaccine (HBV) within 12 hours of birth to these babies will prevent 85-95% of infections. From 2002-4, CDPH evaluated maternal screening and infant vaccination practices at 18 birthing hospitals and provided recommendations for improving prevention practices.

Objectives:
To determine birthing hospitals' current hepatitis B prevention practices.
To determine birthing hospitals' compliance with CDPH recommendations made in 2004.


Methods:
We reviewed maternal hepatitis B screening results and infant vaccination records associated with the first 60 births after October 1, 2005 in Chicago birthing hospitals. We determined the percentage of women screened, infants vaccinated and charts with appropriate documentation for participating hospitals.

Results:
We reviewed 1,390 maternal and infant chart pairs at 24 birthing hospitals. Overall, 83% of women were screened prenatally, 81% of women without prenatal screening were screened upon admission and 96% of infants received the HBV before discharge. When the analysis was limited to the 18 hospitals evaluated in 2002, more women were screened prenatally (84% vs 68%), more women without prenatal screening were screened on admission (91% vs 79%), more infant charts had maternal hepatitis B status documentation (83% vs. 56%) and more infants were vaccinated prior to discharge (95% vs 71%) in 2006 vs. 2002.

Conclusions:
Since 2002, perinatal hepatitis B prevention practices have improved in Chicago birthing hospital. However, areas for improvement still exist (e.g., 19% of women without prenatal screening results were not screened upon admission). CDPH will provide individual hospital feedback and regional training sessions to provide recommendations for improvement.