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Nurses' experiences with implementation of a contraceptive shared decision making tool
Dissertation   Open access

Nurses' experiences with implementation of a contraceptive shared decision making tool

Barbara Osborne
Doctor of Nursing Practice (D.N.P.), Drexel University
2015
DOI:
https://doi.org/10.17918/etd-6730
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Abstract

Contraception Behavior Nursing
Unintended pregnancy is a dilemma that affects a significant proportion of American women and families. Reliable and consistent use of contraception has the potential to decrease unintended pregnancy. Health care providers caring for women seeking education and counseling related to contraceptive decision making must be prepared to meet both the education and counseling needs of their patients. The purpose of this project was to improve the quality of nurse led contraceptive counseling and increase participation in a shared decision making model for patients desiring contraceptive counseling at the time of voluntary termination of pregnancy. This project was a pretest/post-test design quality improvement intervention pilot project with a qualitative focus group analysis. The World Health Organization's Contraceptive Shared Decision Making Tool was implemented into current clinical practice for patients undergoing contraceptive selection decision making at an abortion care visit. An educational session on the tool was performed and implemented into practice. Nurses at the site participated in a focus group discussion; a pretest/post-test contraceptive counseling skills self- assessment was also administered. Tool usage was found to increase the information nurses gave to patients in counseling, improved the quality of their counseling and increased patient participation in the decision making process. Furthermore, nurses described a feeling of greater access to evidence based contraceptive guidelines and confidence in their counseling skills. The nurses' perception of improvements in both establishing therapeutic relationships and patient empowerment in decision making were also found with tool use. Nursing leaders should consider tool use in areas in which contraceptive counseling occurs, especially for those specialties in which contraception counseling may not be a primary focus.

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