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Increasing the use of long acting reversible contraceptives in primary care
Dissertation   Open access

Increasing the use of long acting reversible contraceptives in primary care

Mary Thornton-Bowmer
Doctor of Nursing Practice (D.N.P.), Drexel University
2018
DOI:
https://doi.org/10.17918/51a9-qe46
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Abstract

Nursing--Practice Primary care (Medicine) Birth control Contraception--Study and teaching Contraceptives--Decision making Nursing
Unintended pregnancy remains a serious public health challenge in the United States (Parks & Peipert, 2016). With renewed emphasis on health prevention, women's needs across the lifespan demand more attention, especially around reproductive health. Women who do not use any contraception method have an increased chance of becoming pregnant annually compared to those using some form of contraception (Bexhell, Guthrie, Cleland & Trussell, 2016) The purpose of this practice improvement project is to promote the use of Long Acting Reversible Contraception (LARC), the most effective form of birth control method (Birgisson, Zhao, Secura, Madden, & Peipert, 2015), along with using standardized evidence-based contraception education. Relationship based care is a culture transformation model and an operational framework that improves safety, quality, patient satisfaction, and staff satisfaction by improving every relationship within an organization (Glembocki & Fitzpatrick, 2015). A Relationship Based Care (RBC) approach was used as a way to communicate with the primary care department and other disciplines. According to Glembocki & Fitzpatrick (2015), RBC is a caring theory that includes the patient in the decision-making process while also building relationships that leads to high-quality patient care. Several discussions with stakeholders i.e. nurse practitioners (NP), registered nurses, medical assistants, health educator, social worker and behavioral health consultants about ways to improve LARC use in a primary care setting were conducted several months prior to the study. A registered nurse (RN) was utilized, as the health educator (HE). The HE used standardized evidence-based contraception education to increase understanding among patients between the ages of 18-45 who are not planning to become pregnant within a year using the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists (ACOG) recommended guidelines for reproductive health (CDC, 2014). Patients who are scheduled for office visits including family planning visit (i.e. sick visits, physical exams, etc.) received standardized, evidence-based contraception education from the HE. The NP was responsible for discussing birth control options at all family planning visits to women who met the criteria and emphasized the use of LARCs. Condom use was encouraged to prevent sexually transmitted infections.

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