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93% of the total variance. The confirmatory factor analysis found a goodness of fit index of .80, a comparative fit index of .95, and a nonnormed fit index of .94. CONCLUSIONS/IMPLICATIONS FOR PRACTICE This scale is valid and reliable for measuring the fertility preparedness of women who receive fertility treatment.BACKGROUND Quality management program implementations in health services are team endeavors that involve all health service personnel. Because they are direct providers of care, nurses are best able to evaluate the influence of quality management program implementations on the health services and quality of care provided by hospitals. PURPOSE The aim of this study was to develop an instrument to determine how nurses perceive the implementation of quality management programs in hospitals. Furthermore, the nurses' perceptions of the influence of these implementations on the quality of patient care and their job satisfaction were examined. METHODS A descriptive, comparative, cross-sectional online survey was conducted using a convenience sample (N = 388) of practicing nurses working at public and university hospitals where quality management programs were implemented. Nurses' perceptions of the implementations were analyzed using confirmatory factor analysis, whereas the influence of nurses' perceptions of qualido not participate effectively in quality management program implementations, they perceive these efforts as unnecessary and the responsibility of the quality control department. It is very important to ensure that all care-service providers participate to effectively implement quality management programs in hospitals and to encourage the adoption of a culture of patient safety in all institutions.OBJECTIVES To estimate the prevalence of inappropriate antihypertensive polytherapy in Australia. METHODS We used a nationally representative 10% sample of Pharmaceutical Benefits Scheme (PBS) eligible Australians and their dispensing history to identify people aged 18+ years exposed to at least one PBS-listed antihypertensive between 2012 and 2018. We measured prevalence of antihypertensive polypharmacy (≥40 days concomitant exposure), inappropriate antihypertensive combinations (against guideline recommendations; within-class polytherapy) and combinations to be used with caution. RESULTS Almost half (47.5%) of people using antihypertensives in 2018 experienced polytherapy. Among these, 2.4% had an inappropriate combination (1.5% against guidelines; 1.0% within-class polytherapy). Inappropriate combinations were more prevalent in people experiencing polytherapy with three (3.7%) or four (16.1%) antihypertensive medicines than people on dual therapy (0.7%). Inappropriate combinations occurred at a lower rate in people using fixed-dose rather than free-drug combinations for dual therapy (0 vs. 0.7%) and in those using three antihypertensives (2.4 vs. 7.3%); this was not the case for people using four or more antihypertensives (15.5 vs. 16.1%). Between 2013 and 2018, the prevalence of antihypertensive polytherapy was relatively stable (49-47%); however, the prevalence of inappropriate combinations among these patients halved (from 5.1 to 2.4%). CONCLUSION Antihypertensive polytherapy in Australia is common, but the prevalence of inappropriate combinations is low and decreasing over time, suggesting strong awareness of Australian clinical guidelines. However, in 2018, approximately 49 000 Australian adults experienced inappropriate polytherapy; prescribing of fixed-dose combinations in patients on dual or triple therapy may further reduce this inappropriate care, although increased vigilance treating patients with more than 3 antihypertensives is required.Papular epidermal nevus with "skyline" basal cell layer (PENS) is a keratinocytic nevus that can occur sporadically or has a familial transmission. There are 5 families reported with PENS, in which there are 2 family members affected with each case. We present the sixth familial case, with the peculiarity of being the first time in which there are 3 family members with PENS, while reviewing the other cases described until now. In addition, we present a new histopathological finding, an inflammatory lichenoid infiltrate on the upper dermis in PENS lesions. This finding could be the result of trauma to the biopsied lesion, or it may represent a new inflammatory histological variant.INTRODUCTION Epilepsy is a common chronic disease with transient brain dysfunction and critically influences the quality of patients' family life. The aim of this study was to analyze the effectiveness of family management style on family quality of life in children. METHODS We randomized 130 children to either the intervention group (n = 65) or the control group (n = 65). Family management style combined with routine care was applied in the intervention group within the first 24 hours after admission, whereas only routine care was applied in the control group. Family management style contains 3 steps involve families into the intervention group and determine treatment plan, educate parents on how to manage their family, and monitor quality of home management. Scores on the Beach Center Family Quality of Life Scale (FQOL) of 2 groups were collected at 3 time points within the first 24 hours after admission (T1), 6 months after discharge (T2), and 12 months after discharge (T3). Repeated-measures analysis of variance of FQOL scores was used to evaluate difference. RESULTS Full scores and each subscale's scores on FQOL in the control group and the intervention group at T1 had no statistical significance (P > .05). Scores on FQOL at T2 and T3 increased in the intervention group, but there was almost no change in the control group, with statistical significance between the intervention group and the control group (P .05). CONCLUSION The family management style can effectively improve the family quality of life in children with epilepsy, especially at the satisfaction level of family emotional well-being and disability-related support.BACKGROUND Syphilis staging is important to determine treatment, post-treatment monitoring, and sexual partner follow-up. Many prescribers find syphilis staging to be challenging. Current guidelines for the management of patients diagnosed with syphilis provide little direction aside from an overview of some common symptoms and directing providers to stage cases in conjunction with experienced colleagues. LOCAL PROBLEM In Canada and the United States, the rate of infectious syphilis has increased noticeably since 2000. Given the increase in rates of syphilis, it is important for all clinicians to understand how to appropriately manage patient care to reduce rates of infection. METHODS AND INTERVENTIONS A clinical algorithm was developed to stage infectious syphilis. Temsirolimus supplier This was tested among nurse practitioners and physicians in a sexually transmitted infection clinic. The algorithm was developed based on a review of the available United States, Canadian, and British practice guidelines. RESULTS Project results demonstrated that this resource could be a relevant practice tool for providers in multiple clinical settings to ensure that patients receive appropriate diagnosis, staging, and treatment of syphilis infection.