Abstract
Implementation of specific health maintenance recommendations into practice settings has been difficult. A nurse-initiated health maintenance remainder system into a university-based internal medicine practice setting. Performance of selected items (Papanicolaou smear, stool examination for occult blood, breast examination and influenza immunization) was compared in the practice before and after institution of the system. The system required no additional personnel and was quickly learned by the nursing staff. There were significant increases in the performance of stool examination for occult blood (32-47%), breast examination (29-46%), and influenza immunization (18-40%) after the remainder system was introduced. A nurse-initiated health maintenance remainder system is a feasible and effective method for implementing periodic health examination procedures into a practice setting.