Improving APRN Utilization of Long Acting Reversible Contraceptives in a Family Planning Clinic

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Kimberly Hardy (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: Current contraceptive clinical practice guidelines (CPGs) recommend the use of long acting reversible contraceptives (LARCs) , the most effective contraceptives , to prevent unplanned pregnancy in women seeking contraceptive services. Despite this recommendation , healthcare providers worldwide prescribe moderately effective contraceptive methods more often than the most effective ones. Healthcare provider nonadherence to contraceptive CPGs have been attributed to provider , system , and patient level barriers. Nonadherence to evidence-based contraceptive CPGs contributes to poor long-term patient outcomes (i.e. unintended pregnancy and related sequala). An evidence-based practice change project was implemented at a family planning clinic in a local health department setting to increase Advanced Practice Registered Nurses' (APRN's) utilization of LARCs. A multicomponent intervention , consisting of one academic detailing session , implementation of four structured documentation templates , and a clinician reminder system , was implemented to improve the intermediate outcome of increasing APRNs utilization of LARCs in women at risk for unintended pregnancy. The multicomponent intervention caused changes in clinical structure and processes , which resulted in a 42% increase in APRNs utilization of LARCs 12 weeks post-intervention. Interventions designed not only to address identified provider level barriers , but system , and/or patient level barriers may increase APRNs' integration of evidence-based CPGs recommendations into clinical practice.

Additional Information

Publication

Other

Language: English

Date: 2017

Keywords

Long acting reversible contraception (LARC); utilization; quality improvement; adherence barriers; practice integration; Donabedian quality measures; academic detailing sessions; structured documentation templates; reminder systems; evidence-based practice (EBP); multicomponent interventions

Subjects

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