IMPLEMENTATION OF AN EVIDENCE-BASED EDUCATIONAL PROGRAM TO PROMOTE THE CORRECT USE OF A SUBDERMAL CONTRACEPTIVE IMPLANT IN WOMEN OF CHILD BEARING AGE Public Deposited

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Last Modified
  • March 20, 2019
Creator
  • Apple, Jennifer
    • Affiliation: School of Nursing
Abstract
  • Background: Unintended pregnancy remains one of the top problems women face across the United States, although the rate has decreased 18% in four years due to an increase in the use highly effective long acting reversible contraceptives (LARCs), specifically the subdermal implant. However, irregular or prolonged bleeding is the most common side effect associated with the subdermal implant and primary cause for early removal. Proper provider education on the management of side effects of the implant may improve how women tolerate the implant, decreasing rates of early removal. Purpose: The purpose of this project was to implement a system wide educational program for providers and staff at a local health department on optimizing counseling patients about the subdermal contraceptive implant to improve provider knowledge and decrease early removal rates. Methods: A quasi-experimental design based on Lippitt’s seven step theory was used to test the impact of a system wide educational intervention for providers on identifying irregular vaginal bleeding and potential treatments, and provision of provider contact information for patients receiving the subdermal implant. An informational brochure was also created as a tool for patients, and staff were educated on how to utilize the tool during patient encounters for implant insertion. Implementation consisted of education during in-person meetings with all staff members. Records of patients between January 1, 2017 to June 30, 2017 were randomly reviewed retrospectively and a 3-month post implementation chart review was conducted for comparison with pre-intervention data. Results: The current project indicated the system wide educational intervention for providers and staff on optimizing counseling patients on the subdermal contraceptive implant and its common side-effects in females of childbearing age elicited a statistically significant change in knowledge among clinic staff at the NRC (Wilcoxon signed-ranked z = -2.371, p = 0.018). There was also a significant impact on the number of subdermal implants removed (p = 0.015) between pre and post implementation of the education program. Conclusion: Implementation of a system wide educational program led to improved staff knowledge regarding evidence-based counseling for subdermal contraceptive implants. Based on these findings, standardizing provider-led education to counsel female patients on the subdermal contraceptive implant can lead to effective treatment of common side effects and reduce early discontinuation rates, ultimately preventing unwanted pregnancy.
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Advisor
  • Tesh, Anita
  • Caruso, Diane
  • Maness, Patricia
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2018
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