Patient satisfaction with the communication process used to inform them of the results of their...
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Conclusion(s): The measurements obtained in this trial show (1) there are no significant differences in the volume delivered with the 1 mL syringes and the pen-injector; (2) the device with the most variability (SD 0.010) was the pen-injector; and (3) both the BD syringe and the Serono/Terumo customized syringe are more precise (SD 0.003) than the pen-injector. (1) Voortman G, et al. (1999) Hum. Reprod., 14:1698-1702 Wednesday, October 15, 2003 4:15 P.M. O-224 Patient satisfaction with the communication process used to inform them of the results of their first assisted reproductive technology cycle. Christine Wagner, Carla Groh. IVF Michigan, Rochester Hills, MI; Univ of Detroit Mercy, Detroit, MI. Objective: To describe the communication process currently used by health professionals when informing couples of the outcome of their first Assisted Reproductive Technology (ART) cycle and to evaluate patient satisfaction with this process. Design: A non-experimental, prospective, cross sectional design was used. Materials and Methods: The researchers developed a written questionaire based on a review of relevant literature. Multiple choice questions, open- ended queries and Likert scales addressed aspects of communication. Sixty- six couples who met study criteria and gave informed consent received the questionaire by mail three weeks following embryo transfer in their first ART cycle. T-test, Chi Square and Pearson’s r (SPSS 11.5) were used to analyze data. Results: Forty-six questionaires were completed and returned (70% re- sponse rate). There were no differences between the responders and non- responders on mean age of the female partner, ethnicity or cycle outcome. The majority of couples were Caucasian (80%), the mean age of the women was 33 years (SD 4.9) with a range of 22 to 44 years, and 67% of the couples (N 31) were pregnant after their first ART cycle. The majority (96%) received the results over the phone with the female partner receiving the call (91%). Fifty-nine percent of the respondents (N 27) reported being alone when they received the results. Twenty-six percent (N 12) reported that their partner was with them when they received the results. Fifty percent (N 23) were at home, 39% (N 18) were at work. Eight-seven percent of respondents (N 40) voiced satisfaction with the communication process. However, 28% (N 13) agreed with the statement “there is a better way of communicating the results of the IVF cycle”. This subset of respondents was more likely to have received negative results (p .048) and was more likely to have been alone when receiving these results (p .043). Satisfaction with the communication process was independent of the location where the results were received. Fifty-four percent of respondents (N 25) would have liked a follow-up call from the nurse; 61% (N 28) would have liked a follow-up call from the physician. Statistical differences in three areas were noted between respondents who received positive results compared with those who received negative results. Couples who were not pregnant were less likely to feel comfortable calling the clinic for support after receiving the results (p .047), and they were less likely to feel the way the results were communicated helped them to feel better about the results (p .001). Couples who were pregnant were more likely to desire written instructions regarding what to do next com- pared with couples who were not pregnant (p .049). Conclusion: Couples undergoing their first ART cycle report a high level of satisfaction with the current communication process. However, encour- aging couples to receive the results together may be beneficial. Follow-up phone calls may further increase satisfaction by providing support to cou- ples who receive negative results and confirmation of plan of care to those who receive positive results. Wednesday, October 15, 2003 4:30 P.M. O-225 Assessing possible wastage associated with commonly used syringes for drug administration in controlled ovarian stimulation. Shira Benson, G. Scot Hamilton, Mathias Gysler. ISIS Regional Fertility Ctr, Mississauga, ON, Canada. Objective: During COS for ART many different medications are admin- istered daily by subcutaneous or intramuscular injections. Utilizing the most patient-friendly COS regimen, with oral contraceptive pill pre-treatment, ten days of follicular phase treatment, including one daily dose of rFSH, 4 doses of GnRH antagonist, one dose of hCG and the use of vaginal progesterone, 15 injections will be administered. If GnRH agonist is used for 14-21 days instead of a GnRH antagonist, plus two daily doses of FSH and hMG, plus progesterone in oil, the number of injections is closer to 100. Variables, such as injection technique errors and compliance, are known to affect final treatment outcomes. A variable not widely examined is the precision of drug delivery by the most commonly used syringes. This study was undertaken to determine if there is a true difference between the amount of drug delivered by different brands of syringes, to precisely measure these differ- ences and to detect the origin of these differences. Design: Comparative trial. Materials and Methods: Four syringes were examined from three differ- ent suppliers: Becton Dickinson (BD) 3 mL leur-lok, BD and Monoject(r) 1 mL, with detachable 27G 1/2 inch needle, and Serono/Terumo cus- tomized 1 mL syringe with fixed 27G 1/2 inch needle. Knowing that 1 mL Sterile Water for Injection, USP (SWI) weighs 1 gm, 1 mL SWI was drawn up in each syringe. The 1 mL SWI in each syringe was then expelled into a tube that was weighed before and after receiving the SWI, utilizing a highly sensitive AX204 Mettler Toledo-Sartorius balance. To detect any potential variation, the four syringes were weighed five times under the following three conditions during the trial: (A) syringe needle, empty, (B) syringe needle 1 mL SWI, and (C) syringe needle after delivering 1 mL SWI, as well as the weight of the SWI collected in the tube receptacle. The mean of these measurements per syringe was calculated. Results: After delivering 1 mL SWI the mean weight of the solution was 0.98 0.02, 0.99 0.005, 1.02 0.015, and 0.99 0.005 gm, for BD 3 mL, BD 1 mL, Monoject 1 mL and Serono/Terumo 1 mL, respectively. Hence, the same amount of solution was delivered by each syringe (mean 0.997 0.002). The differences in the mean weight of the syringes before and after delivering the solution were 0.056 gm for BD 3mL (5.6%), 0.056 gm for BD 1 mL (5.6%), 0.028 gm for Monoject 1 mL (2.8%) and 0.002 gm for Serono/Terumo 1 mL (0.22%). These differences represent the solution that remains in the dead space of the syringe hub and in the cavity of the needle. Conclusion(s): The results of this trial show that there is minimal vari- ability in the amount of drug delivered by the syringes tested, although the most precise syringe delivering the most consistent dose as measured by Weights A and C was the Serono/Terumo customized syringe. Wednesday, October 15, 2003 4:45 P.M. O-226 “Everything came with a price:” Women’s decision-making regarding multifetal pregnancy reduction. Kate S. Collopy. Univ of New Hamp- shire, Durham, NH. Objective: To describe women’s experiences regarding their decisions to undergo or forgo multifetal pregnancy reduction (MFPR). Design: Phenomenological. Materials and Methods: Participants were accessed via the Usenet news- groups alt.infertility.parenting and alt.parenting.twins-triplets, through two e-mail discussion lists, the Twins List for families of twins, and the Triplet List, for families with triplets or other higher order multiples, and through notices distributed by the National Organization of Mothers of Twins Clubs. Following receipt of IRB approval, notices describing the study and inviting S86 Abstracts Vol. 80, Suppl. 3, September 2003
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Transcript of Patient satisfaction with the communication process used to inform them of the results of their...
Conclusion(s): The measurements obtained in this trial show (1) there areno significant differences in the volume delivered with the 1 mL syringesand the pen-injector; (2) the device with the most variability (SD � 0.010)was the pen-injector; and (3) both the BD syringe and the Serono/Terumocustomized syringe are more precise (SD � 0.003) than the pen-injector.
(1) Voortman G, et al. (1999) Hum. Reprod., 14:1698-1702
Wednesday, October 15, 20034:15 P.M.
O-224
Patient satisfaction with the communication process used to informthem of the results of their first assisted reproductive technology cycle.Christine Wagner, Carla Groh. IVF Michigan, Rochester Hills, MI; Univ ofDetroit Mercy, Detroit, MI.
Objective: To describe the communication process currently used byhealth professionals when informing couples of the outcome of their firstAssisted Reproductive Technology (ART) cycle and to evaluate patientsatisfaction with this process.
Design: A non-experimental, prospective, cross sectional design wasused.
Materials and Methods: The researchers developed a written questionairebased on a review of relevant literature. Multiple choice questions, open-ended queries and Likert scales addressed aspects of communication. Sixty-six couples who met study criteria and gave informed consent received thequestionaire by mail three weeks following embryo transfer in their firstART cycle. T-test, Chi Square and Pearson’s r (SPSS 11.5) were used toanalyze data.
Results: Forty-six questionaires were completed and returned (70% re-sponse rate). There were no differences between the responders and non-responders on mean age of the female partner, ethnicity or cycle outcome.The majority of couples were Caucasian (80%), the mean age of the womenwas 33 years (SD 4.9) with a range of 22 to 44 years, and 67% of thecouples (N � 31) were pregnant after their first ART cycle. The majority(96%) received the results over the phone with the female partner receivingthe call (91%). Fifty-nine percent of the respondents (N � 27) reportedbeing alone when they received the results. Twenty-six percent (N � 12)reported that their partner was with them when they received the results.Fifty percent (N � 23) were at home, 39% (N � 18) were at work.
Eight-seven percent of respondents (N � 40) voiced satisfaction with thecommunication process. However, 28% (N � 13) agreed with the statement“there is a better way of communicating the results of the IVF cycle”. Thissubset of respondents was more likely to have received negative results (p �.048) and was more likely to have been alone when receiving these results(p � .043). Satisfaction with the communication process was independentof the location where the results were received.
Fifty-four percent of respondents (N � 25) would have liked a follow-upcall from the nurse; 61% (N � 28) would have liked a follow-up call fromthe physician.
Statistical differences in three areas were noted between respondents whoreceived positive results compared with those who received negative results.Couples who were not pregnant were less likely to feel comfortable callingthe clinic for support after receiving the results (p � .047), and they wereless likely to feel the way the results were communicated helped them tofeel better about the results (p � .001). Couples who were pregnant weremore likely to desire written instructions regarding what to do next com-pared with couples who were not pregnant (p � .049).
Conclusion: Couples undergoing their first ART cycle report a high levelof satisfaction with the current communication process. However, encour-aging couples to receive the results together may be beneficial. Follow-upphone calls may further increase satisfaction by providing support to cou-ples who receive negative results and confirmation of plan of care to thosewho receive positive results.
Wednesday, October 15, 20034:30 P.M.
O-225
Assessing possible wastage associated with commonly used syringes fordrug administration in controlled ovarian stimulation. Shira Benson, G.
Scot Hamilton, Mathias Gysler. ISIS Regional Fertility Ctr, Mississauga,ON, Canada.
Objective: During COS for ART many different medications are admin-istered daily by subcutaneous or intramuscular injections. Utilizing the mostpatient-friendly COS regimen, with oral contraceptive pill pre-treatment, tendays of follicular phase treatment, including one daily dose of rFSH, 4 dosesof GnRH antagonist, one dose of hCG and the use of vaginal progesterone,15 injections will be administered. If GnRH agonist is used for 14-21 daysinstead of a GnRH antagonist, plus two daily doses of FSH and hMG, plusprogesterone in oil, the number of injections is closer to 100. Variables,such as injection technique errors and compliance, are known to affect finaltreatment outcomes. A variable not widely examined is the precision of drugdelivery by the most commonly used syringes. This study was undertakento determine if there is a true difference between the amount of drugdelivered by different brands of syringes, to precisely measure these differ-ences and to detect the origin of these differences.
Design: Comparative trial.Materials and Methods: Four syringes were examined from three differ-
ent suppliers: Becton Dickinson (BD) 3 mL leur-lok, BD and Monoject(r)1 mL, with detachable 27G � 1/2 inch needle, and Serono/Terumo cus-tomized 1 mL syringe with fixed 27G � 1/2 inch needle. Knowing that 1mL Sterile Water for Injection, USP (SWI) weighs 1 gm, 1 mL SWI wasdrawn up in each syringe. The 1 mL SWI in each syringe was then expelledinto a tube that was weighed before and after receiving the SWI, utilizing ahighly sensitive AX204 Mettler Toledo-Sartorius balance. To detect anypotential variation, the four syringes were weighed five times under thefollowing three conditions during the trial: (A) syringe � needle, empty, (B)syringe � needle � 1 mL SWI, and (C) syringe � needle after delivering1 mL SWI, as well as the weight of the SWI collected in the tube receptacle.The mean of these measurements per syringe was calculated.
Results: After delivering 1 mL SWI the mean weight of the solution was0.98 � 0.02, 0.99 � 0.005, 1.02 � 0.015, and 0.99 � 0.005 gm, for BD 3mL, BD 1 mL, Monoject 1 mL and Serono/Terumo 1 mL, respectively.Hence, the same amount of solution was delivered by each syringe (mean0.997 � 0.002). The differences in the mean weight of the syringes beforeand after delivering the solution were 0.056 gm for BD 3mL (5.6%), 0.056gm for BD 1 mL (5.6%), 0.028 gm for Monoject 1 mL (2.8%) and 0.002 gmfor Serono/Terumo 1 mL (0.22%). These differences represent the solutionthat remains in the dead space of the syringe hub and in the cavity of theneedle.
Conclusion(s): The results of this trial show that there is minimal vari-ability in the amount of drug delivered by the syringes tested, although themost precise syringe delivering the most consistent dose as measured byWeights A and C was the Serono/Terumo customized syringe.
Wednesday, October 15, 20034:45 P.M.
O-226
“Everything came with a price:” Women’s decision-making regardingmultifetal pregnancy reduction. Kate S. Collopy. Univ of New Hamp-shire, Durham, NH.
Objective: To describe women’s experiences regarding their decisions toundergo or forgo multifetal pregnancy reduction (MFPR).
Design: Phenomenological.Materials and Methods: Participants were accessed via the Usenet news-
groups alt.infertility.parenting and alt.parenting.twins-triplets, through twoe-mail discussion lists, the Twins List for families of twins, and the TripletList, for families with triplets or other higher order multiples, and throughnotices distributed by the National Organization of Mothers of Twins Clubs.Following receipt of IRB approval, notices describing the study and inviting
S86 Abstracts Vol. 80, Suppl. 3, September 2003
