Improving hysterosalpingogram confirmatory test follow-up after Essure hysteroscopic sterilization.
BACKGROUND
Given the need for a 90-day post-Essure hysterosalpingogram (HSG) to confirm proper tubal placement and occlusion, we examined the impact of dedicating a staff nurse to schedule HSG appointments, call with appointment reminders and track HSG compliance for patients who had Essure.


METHODS
We performed a retrospective chart review for patients who underwent Essure sterilization between October 2003 and January 2009. We compared rates of HSG compliance and confirmed tubal occlusion for patients before February 2008 with rates after the protocol change occurred.


RESULTS
Seventy-eight percent of preintervention patients were compliant with at least one HSG following Essure placement compared to 90.9% in the post-intervention group (p value=.033). Tubal occlusion was confirmed by postprocedure HSGs for 123/173 patients (71.1%) in the preintervention group and 48/55 patients (87.3%) in the postintervention group. Patients followed by our staff after our protocol change were more likely to undergo post-Essure compliance (Odds ratio= 2.7, confidence interval = 1.2-7.1, p=.01).


CONCLUSIONS
Dedicating a staff nurse to track patients' HSG follow-up as a multicheck system resulted in an improvement in HSG compliance and rates of confirmed tubal placement and occlusion.
Guiahi
Maryam
M
Division of Family Planning, Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA. Mg2852@columbia.edu
Goldman
Kara N
KN
McElhinney
Margaret M
MM
Olson
Christopher G
CG
D000328:Adult; D001071:Appointments and Schedules; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000451:nursing; D015907:Hysteroscopy; D008499:Medical Records; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods; D011184:Postoperative Period; D017010:Reminder Systems; D012189:Retrospective Studies; D013246:Sterilization, Tubal / Q000295:instrumentation / Q000379:methods*