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Integrating IUD Provision into Your Practice: Site Preparedness, Staff Training, and Procedural Steps

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Optimizing IUD Delivery for Adolescents and Young Adults

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Abstract

Many resources exist on how to optimize IUD service delivery and guide clinics in developing IUD programs and training providers. Implementing IUD services will go more smoothly if all stakeholders are involved and all clinic staff members are operating at their highest skill level. Clinics can streamline access to adolescents’ and young adults’ preferred method by optimizing clinic-wide training in IUD counseling, skills, and clinic flow. Having a standardized approach to IUD insertion and removal procedures, which takes into account both the behavioral components and cognitive reasoning for these, helps providers to improve standard IUD provision for adolescents and young adults, and to work through complications if they arise. This chapter will help readers to identify initial steps to establish readiness for introducing IUD services into an adolescent and young adult practice, as well as how to access proctoring supervision in order to successfully insert and remove IUDs. Detailed steps for IUD set-up, placement, and removal are outlined, along with guidelines on compiling supplies and materials necessary for IUD procedures.

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Abbreviations

AYA:

Adolescent and young adult

BMI:

Body mass index

CuT380A IUD:

Copper IUD

EC:

Emergency contraception

EHR:

Electronic health record

IUD:

Intrauterine device

LMP:

Last menstrual period

STI:

Sexually transmitted infection

UPIC:

Unprotected intercourse

References

  1. World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP). Knowledge for health project. Family planning: a global handbook for providers (2018 update). Baltimore/Geneva: CCP and WHO; 2018. [Internet]. [cited 1 Dec 2018]. Available: http://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-eng.pdf.

  2. ACOG Committee Opinion No. 735. Adolescents and long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol. 2018;131:e130–9.

    Article  Google Scholar 

  3. Society for Adolescent Health and Medicine. Improving knowledge about, access to, and utilization of long-acting reversible contraception among adolescents and young adults. J Adolesc Health. 2017;60:472–4.

    Article  Google Scholar 

  4. Ott MA, Sucato GS, Committee on Adolescence. Contraception for adolescents. Pediatrics. 2014;134:e1257–81.

    Google Scholar 

  5. Harper CC, Rocca CH, Thompson KM, Morfesis J, Goodman S, Darney PD, et al. Reductions in pregnancy rates in the USA with long-acting reversible contraception: a cluster randomised trial. Lancet. 2015;386:562–8.

    Article  Google Scholar 

  6. Harper CC, Stratton L, Raine TR, Thompson K, Henderson JT, Blum M, et al. Counseling and provision of long-acting reversible contraception in the US: national survey of nurse practitioners. Prev Med. 2013;57:883–8.

    Article  Google Scholar 

  7. Thompson KMJ, Rocca CH, Kohn JE, Goodman S, Stern L, Blum M, et al. Public funding for contraception, provider training, and use of highly effective contraceptives: a cluster randomized trial. Am J Public Health. 2016;106:541–6.

    Article  Google Scholar 

  8. Greenberg KB, Makino KK, Coles MS. Factors associated with provision of long-acting reversible contraception among adolescent health care providers. J Adolesc Health. 2013;52:372–4.

    Article  Google Scholar 

  9. LB Presler, RS Fehrman, R Gordon, K Turner. Mentoring for service-delivery change: a trainer’s handbook. Chapel Hill, NC: Ipas; 2006. [Internet]. [cited 1 Dec 2018]. Available: https://www.go2itech.org/HTML/CM08/toolkit/links/print/Mentoring/Mentoring_Handbook_Ipas.pdf.

  10. Bergin A, Tristan S, Terplan M, Gilliam ML, Whitaker AK. A missed opportunity for care: two-visit IUD insertion protocols inhibit placement. Contraception. 2012;86:694–7.

    Article  Google Scholar 

  11. Pritt NM, Norris AH, Berlan ED. Barriers and facilitators to adolescents’ use of long-acting reversible contraceptives. J Pediatr Adolesc Gynecol. 2017;30:18–22.

    Article  Google Scholar 

  12. Gavin L, Pazol K. Update: providing quality family planning services - recommendations from CDC and the U.S. office of population affairs, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:231–4.

    Article  Google Scholar 

  13. Online training | Beyond the pill [Internet]. [cited 1 Dec 2018]. Available: http://beyondthepill.ucsf.edu/online-training.

  14. Bartz D, Paris A, Maurer R, Gardner R, Johnson N. Medical student simulation training in intrauterine contraception insertion and removal: an intervention to improve comfort, skill, and attitudes. Contracept Reprod Med. 2016;1:3.

    Article  Google Scholar 

  15. Dodge LE, Hacker MR, Averbach SH, Voit SF, Paul ME. Assessment of a high-fidelity mobile simulator for intrauterine contraception training in ambulatory reproductive health centres. J Eur CME. 2016;5:30416.

    Article  Google Scholar 

  16. Nitschmann C, Bartz D, Johnson NR. Gynecologic simulation training increases medical student confidence and interest in women’s health. Teach Learn Med. 2014;26:160–3.

    Article  Google Scholar 

  17. Khadivzadeh T, Erfanian F. The effects of simulated patients and simulated gynecologic models on student anxiety in providing IUD services. Simul Healthc. 2012;7:282–7.

    Article  Google Scholar 

  18. Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB. Simulation in healthcare education: a best evidence practical guide. AMEE guide no. 82. Med Teach. 2013;35:e1511–30.

    Article  Google Scholar 

  19. Lofaso DP, DeBlieux PM, DiCarlo RP, Hilton C, Yang T, Chauvin SW. Design and effectiveness of a required pre-clinical simulation-based curriculum for fundamental clinical skills and procedures. Med Educ Online. 2011;16. https://doi.org/10.3402/meo.v16i0.7132.

    Article  Google Scholar 

  20. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003;78:783–8.

    Article  Google Scholar 

  21. Okuda Y, Bryson EO, DeMaria S Jr, Jacobson L, Quinones J, Shen B, et al. The utility of simulation in medical education: what is the evidence? Mt Sinai J Med. 2009;76:330–43.

    Article  Google Scholar 

  22. Stitely ML, Cerbone L, Nixon A, Bringman JJ. Assessment of a simulation training exercise to teach intrauterine tamponade for the treatment of postpartum hemorrhage. J Midwifery Womens Health. 2011;56:503–6.

    Article  Google Scholar 

  23. Daniels K, Lipman S, Harney K, Arafeh J, Druzin M. Use of simulation based team training for obstetric crises in resident education. Simul Healthc. 2008;3:154–60.

    Article  Google Scholar 

  24. Ennen CS, Satin AJ. Training and assessment in obstetrics: the role of simulation. Best Pract Res Clin Obstet Gynaecol. 2010;24:747–58.

    Article  Google Scholar 

  25. Goodman S, McNeil S, Shih G. Simulation for managing hemorrhage as a complication of uterine aspiration. MedEdPORTAL. 2015; https://doi.org/10.15766/mep_2374-8265.10296.

  26. Goodman S. UCSF Bixby beyond the pill: protocol for the provision of IUD; LARC proctoring toolkit [Internet]. 2018 [cited 6 Jan 2019]. Available: https://beyondthepill.ucsf.edu/clinic-tools.

  27. Steinauer J, Preskill F, Robertson P. Training medical students in intrauterine procedures using papayas. Med Educ. 2007;41:1099–100.

    Article  Google Scholar 

  28. Levine AI, DeMaria S Jr, Schwartz AD, Sim AJ. The comprehensive textbook of healthcare simulation. New York: Springer Science & Business Media; 2013.

    Book  Google Scholar 

  29. Sanders A, Wilson RD. Simulation training in obstetrics and gynaecology residency programs in Canada. J Obstet Gynaecol Can. 2015;37:1025–32.

    Article  Google Scholar 

  30. IUD competency checklist. In: Beyond the pill [Internet]. [cited 2 Dec 2018]. Available: http://beyondthepill.ucsf.edu/sites/beyondthepill.ucsf.edu/files/Beyond%20the%20Pill%20IUD%20Competency%20Checklists.pdf.

  31. Gubrium AC, Mann ES, Borrero S, Dehlendorf C, Fields J, Geronimus AT, et al. Realizing reproductive health equity needs more than Long-Acting Reversible Contraception (LARC). Am J Public Health. 2016;106:18–9.

    Article  Google Scholar 

  32. Higgins JA. Celebration meets caution: LARC’s boons, potential busts, and the benefits of a reproductive justice approach. Contraception. 2014;89:237–41.

    Article  Google Scholar 

  33. Potter J, Koyama A, Coles MS. Addressing the challenges of clinician training for long-acting reversible contraception. JAMA Pediatr. 2015;169:103–4.

    Article  Google Scholar 

  34. MOU LARC clinical placement agreement template. In: Reproductive health access project [Internet]. [cited 1 Dec 2018]. Available: http://www.reproductiveaccess.org/wp-content/uploads/2015/02/LARC-Clinical-Placement-Agreement-Template.doc.

  35. Rubin SE, Maldonado L, Fox K, Rosenberg R, Wall J, Prine L. Establishing and conducting a regional, hands-on long-acting reversible contraception training center in primary care. Womens Health Issues. 2018;28:375–8.

    Article  Google Scholar 

  36. Mays A, Harper C, Freeman L, Biggs MA. The role of proctoring to increase LARC access in community health centers. 2016 American public health conference; 2016 Nov.

    Google Scholar 

  37. Cason P, Goodman S. Protocol for provision of intrauterine contraception. San Francisco: UCSF Bixby Center Beyond the Pill; 2016. [Internet]. [cited 2 Dec 2018]. Available: https://beyondthepill.ucsf.edu/sites/beyondthepill.ucsf.edu/files/Beyond%20the%20Pill%20IUC%20Protocol.pdf.

  38. This is how I teach: no touch technique for copper IUD - innovating education in reproductive health. In: Innovating education in reproductive health [Internet]. 17 Oct 2018 [cited 10 Jan 2019]. Available: https://innovating-education.org/2018/10/this-is-how-i-teach-no-touch-technique-for-cooper-iud/.

  39. Coles MS. IUD insertion task analysis. Developed through funding by the Society of Family Planning; Report no.: SFP5–11.

    Google Scholar 

  40. Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep. 2016;65:1–103.

    Google Scholar 

  41. LILETTA insertion refresher sheet [Internet]. [cited 14 Dec 2018]. Available: https://www.lilettahcp.com/Content/pdfs/SHI_Refresher_Sheet.pdf.

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Author information

Authors and Affiliations

  1. Department of Adolescent Medicine, UCSF Benioff Children’s Hospital Oakland, Oakland, CA, USA

    Lela R. Bachrach

  2. Bixby Center for Global Reproductive Health, Department of Family and Community Medicine, UCSF, San Francisco, CA, USA

    Suzan Goodman

Authors
  1. Lela R. Bachrach
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  2. Suzan Goodman
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Editor information

Editors and Affiliations

  1. Boston University Medical Center, Boston, MA, USA

    Mandy S. Coles

  2. UC Berkley-UCSF Joint Medical Program, Berkeley, CA, USA

    Aisha Mays

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Bachrach, L.R., Goodman, S. (2019). Integrating IUD Provision into Your Practice: Site Preparedness, Staff Training, and Procedural Steps. In: Coles, M., Mays, A. (eds) Optimizing IUD Delivery for Adolescents and Young Adults. Springer, Cham. https://doi.org/10.1007/978-3-030-17816-1_8

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  • DOI: https://doi.org/10.1007/978-3-030-17816-1_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-17815-4

  • Online ISBN: 978-3-030-17816-1

  • eBook Packages: MedicineMedicine (R0)

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