Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Document Type

Poster

Publication Date

12-7-2023

Abstract

BACKGROUND: Approximately 50% of pregnancies in the United States are unintended, leading to negative health, psychosocial, and financial outcomes. Supported methods for preventing unintended pregnancies are promoting education and access to highly effective contraceptive methods, including long-acting reversible contraceptives (LARCs). Studies demonstrate counselor knowledge and bias contribute to underutilization of LARCs, highlighting the need for standardized education.

LOCAL PROBLEM: The setting for this practice improvement project was a rural obstetrical unit in Tennessee where there was no standardized postpartum contraceptive education. Rates of contraceptive use at postpartum discharge were low. The purpose of this project was to implement standardized contraceptive education with the aims of increasing rates of both any birth control method and LARC usage by 25% in the immediate postpartum period.

METHODS: The Evidence-based Practice Improvement (EBPI) model was used to guide this project. The clinical process for implementation of verbal and written standardized education was developed using PDSA (plan-do-study-act) cycles and staff feedback. Pre- and post-implementation rates of contraceptive use and method, as well as staff compliance were measured.

INTERVENTIONS: On admission, nursing staff provided patients with a contraceptive education handout. Verbal reinforcement was completed during postpartum discharge teaching. Patient education and method of birth control was documented in the EHR.

RESULTS: Staff compliance with education was 93%. Use of any birth control method at discharge increased 72.8%. At six-weeks postpartum, rates unexpectedly decreased 3.5%. Use of LARCs at discharge could not be measured due to small sample size, however there was a 9% increase in usage at six weeks.

CONCLUSIONS: The use of standardized contraceptive patient education in the project site increased the selection of any birth control method at discharge and LARCs at six-weeks postpartum. This change is clinically significant and is an important step in reducing negative outcomes associated with unintended pregnancy.

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