Background: In 2011, 45% of the 6.1 million pregnancies in the United States were unintended. Of the unintended pregnancies, 50% were attributed to contraceptive failure or method non-adherence. Long-acting reversible contraceptives (LARCs) are birth control methods consisting of intrauterine devices (IUDs) and the birth control implants that are the most effective forms of reversible contraceptives. LARCs are 20 times more effective than other birth control methods; yet only 5.6% of women are choosing LARCs. Despite multiple pharmacological and non-pharmacological interventions prior to the procedure, 35% of women reported having moderate pain and 42% of women had severe pain associated during the IUD placement
Purpose: The purpose of this quality improvement project was to identify health care providers’ knowledge and practice of pain management methods for IUD insertion in iparous women at a military medical treatment facility (MTF).
Methods: This DNP quality improvement (QI) project used a quantitative descriptive methodology with a pretest-posttest design and educational intervention to identify the current practice and knowledge primary care providers have regarding appropriate pain management for iparous women when placing an IUD.
Results: The providers’ responses reflect a self-efficacy represented by a knowledge increase in the areas of the limited benefit of premedication with either oral analgesics or cervical softening agents, placing an IUD based on the patient’s menstrual cycle, incorporating the use of a local analgesic, and the connection between counseling and patient satisfaction. Limited provider knowledge can be suggested by the varied responses regarding the topic of a CPG. Self-efficacy stayed stable for the areas of post-procedural NSAID use and having the time for counseling regarding expected pain during the procedure.
Conclusion: Improving provider knowledge, skill, and counseling techniques can help decrease the expected and perceived pain for iparous women having an IUD placed leading to an increase of women having IUDs placed. An ultimate goal is to increase IUD use and retention, leading to decreased unintended pregnancy rates, lower maternal and newborn mortality, and improving patient satisfaction when having an IUD placed.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/626355 |
| Date | January 2017 |
| Creators | Pentzien, Carlyn Grace, Pentzien, Carlyn Grace |
| Contributors | Davis, Mary P., Davis, Mary P., Knight, Elizabeth P., Gray, Anne |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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