Strategies for Changing Current Contraceptive Education Methods Essay

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Implementing Structured Contraception Counseling to Increase the Contraception Knowledge of Women of Childbearing Age Seen in a Private Obstetrics and Gynecology Clinic: A Quality Improvement ProjectAbstractThis is an evidence-based project that is aimed implementing a structured contraceptive counseling at our clinical setting. The number of unintended pregnancies that have been reported at our clinic have been on the rise lately, and this is a great concern since it puts pressure on the women and their families. We have analyzed several studies and they all point to the fact that structured contraceptive counseling is beneficial to the providers and to the clients. By using structured contraceptive counseling, it is possible to increase the knowledge of women on contraceptive, which is currently lacking within our clinical setting. The contraceptive counseling being conducted at out clinic is not structured and some of the providers tend to forget what they taught the client, which results in the client not receiving the appropriate information. Having a structured contraceptive counseling has been shown to be more effective and offers the client an opportunity to ask questions and seek clarification for what they did not understand. This paper is aims to demonstrate the efficacy of using a structured contraceptive counseling method and the benefits that will be gained from using such a method. As shown in our literature review, there are numerous methods that a clinic can adopt that are all aimed at implementing a structured education method. We have made recommendations based on our analysis and we recommend that the clinic implement audio-visual and shared decision-making methods.Section One: Introduction and Overview of the ProblemA wide variety of contraceptive methods are available in the United states for women to select in order to prevent or reduce the number of unwanted pregnancies. However, the number of unintended pregnancy rates have remained high and it is estimated that approximately 49% of pregnancies within a year are unintended. The number of unintended pregnancies is most high amongst women who are aged

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The titles and abstracts of the initially identified articles were analyzed in order determine the articles to include and the ones to exclude based on our eligibility criteria. Abstracts that suggested experimental and cohort designs, qualitative methodology, or cross-sectional data were advanced for full article review. However, even after this abstract review we found we had to drill down further and eliminate more articles in order have our agreed number of 5 articles. Therefore, there was need for further review of the abstracts and article to select only the final articles for usage.Literature ReviewStructured counseling is designed to prevent unintended pregnancy. Making use of a structure will allow the client to visualize and understand the information that is being presented in order for them to progress through the stages towards making an informed choice of contraceptive method. According to Farrokh?Eslamlou et al. (2014), structured counseling is standardized in that the client will receive tailored and well-structured information on the use, effectiveness, and side effects of contraceptive methods. This is supported by Dehlendorf, Krajewski, and Borrero (2014), who also posits that structured counseling has been shown to be more effective than normal contraceptive counseling. Communicating the side effects that a particular contraceptive method would have on the client will ensure that the client understands the risks and knows what might go wrong. Dehlendorf, Krajewski, et al. (2014) showed that 37% of the women who choose to use hormonal IUD were not aware that there is a likelihood of them experiencing irregular bleeding. This demonstrates that the women were not properly educated on the contraceptive method that they selected. However, if the women had undergone structured counseling they would have been able to know of the side effects of the contraceptive method and they might have opted to use a method they are more comfortable with (Dehlendorf, Tharayil, et al., 2014). Using structured counseling within a clinical setting will offer the clients an opportunity for them to interact with the healthcare provider. Asking questions is a key component for structured counseling. Allowing the clients to ask questions will ensure that they understand what they are learning and they can be better informed. Questions are a way for making clarification and this has been proven to be quite effective in increasing knowledge of the clients (Secura, Allsworth, Madden, Mullersman, & Peipert, 2010). They are more likely to remember what they have learnt when they are given the chance to ask questions. Using structured counseling is not only beneficial to the client, but also for the healthcare providers. Providers who use a structured process they are more likely to provide complete information, promote compliance, and improve their performance by reducing guesswork. (Farrokh?Eslamlou et al., 2014)Madden, Mullersman, Omvig, Secura, and Peipert (2013) also made use of structured contraceptive counseling. The difference in this study was that a majority of the research team members did not have any formal healthcare training. The study demonstrates that even non-healthcare providers can be effective in delivering contraceptive education if there is a structured method for delivering the education. The study participants were able to select from different contraceptive methods and they understood the methods they were selecting. This study supports what Farrokh?Eslamlou et al. (2014) posits that structured counseling is more effective in ensuring adherence and retention of knowledge amongst women as compared to other methods of contraceptive counseling. Both studies had a success rate of 89% when the providers made use of structured counseling.Visual aids have been the most used educational methods for conducting contraceptive counseling sessions. Dehlendorf, Krajewski, et al. (2014) established that using audio-visual aids was more effective in increasing the understanding of women and knowledge retention as compared to using oral communication. Langston, Rosario, and Westhoff (2010) also established that there was increased usage of contraceptive and continuation of effective contraceptive methods when the clients are educated using audio-visual method. Making use of audio-visual training methods allows the client to both visualize and hear the information that is being presented (Hersh et al., 2017). Combining the two methods allows the client to better understand what they are being taught especially in regards to contraceptive methods and retention of the knowledge. Langston et al. (2010) indicates that 54% of the women who participated in their study were able to select an effective contraceptive method after they underwent the contraceptive education. Visual aids allow the healthcare provider to communicate the efficacy of contraceptive in a meaningful manner. Understanding the efficacy of contraceptive might not be the vital factor that drives method selection, but it has some impact on the method chosen by the client. There is no better way to communicate the side effects of a contraceptive…

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…will then decide on what method they prefer and ask questions before they settle for the selected method. Finally, the client will have a contraceptive method they are comfortable with and they will not need further counseling.Using this conceptual model will allow the healthcare providers to have a structured model for interacting with the client and they will be better able to offer solutions that are in line with the needs of the client (Halpern, Lopez, Grimes, Stockton, & Gallo, 2013; Moreau, Cleland, & Trussell, 2007). Following the phases laid out by the model ensures that the information delivered to the client is easily recalled and they have an opportunity to interact with the provider. This interaction is what will ensure that the client is able to follow through with the selected contraceptive method. Communicating with the client will also allow the client to better understand and increase their knowledge regarding the contraceptive methods being offered. As has been noted the lack of a structured counseling method results in the providers not being able to recall what they advised the client (Stewart et al., 2016). This will also be similar for the client, it is difficult for them to recall what they were taught regarding contraceptive methods and usage if there is no laid-out structure. Implementing the proposed solution will allow the clinic to have a structured approach to contraceptive counseling, which will be beneficial to the client and to the provider. Making use of the proposed solutions will ensure that the provider is able to assist the client to select a method that is appropriate and in line with their preferences. The project will have positive results and there will be increased knowledge of contraception by the women served by the clinic. The overall intention of this project is to reduce the number of unintended pregnancies and increase knowledge of contraception and this will be achieved by employing the usage of structured contraceptive counseling. Providers will also benefit in that they will have an outline that they can rely upon to guide them in the delivery of education to the clients. This structured outline will ensure that the provide does not miss out on any information that the relevant and necessary to the client.Our proposed project will be implemented step by step in order to ensure that all the stakeholders are involved and they understand the change being implemented. It is vital to ensure that everyone is onboard and understands the implications that the practice change will have on the clinic and on their work. The strategy will be designed to work in our clinic setting by first having the healthcare providers undergo a training session where they will be introduced to the proposed educational changes. The training session will also be aimed an empowering the providers withe requisite information and training that they will need in order for them to adopt to the new changes. Thea main stakeholders of this project will be the four healthcare providers who are charged with conducting contraceptive counseling within the clinic. The proposed solution will be to incorporate audio-visual materials for counseling clients and the usage of shared decision-making. These two strategies have been shown to be most effective in impacting the knowledge of women on contraceptives and increasing their retention capacity. All the providers will be taught on how the solutions will assist the clients and how it is beneficial for them and their work. This will make it easy for them to embrace and adopt the proposed solutions. Without provider input, it would be hard for us to implement the change in practice since they are the ones who will be change champions. With the evidence that we have collected it would not be too hard to convince the providers on the need for change in practice. However, it is vital that we be prepared to face some resistance since not everyone is always willing to change and change can be scary. Reassuring the providers by presenting facts on the usage and benefits for the proposed changes will assist the providers to see for themselves how vital the proposed change would be to the practice (Stavor, Zedreck-Gonzalez, & Hoffmann, 2017).Engaging the stakeholders is crucial for the implementation of the proposed solution (Friesen?Storms, Moser, Loo, Beurskens, & Bours, 2015). There will be joint sessions where the change will be proposed and the stakeholders introduced to the changes. The solutions and their advantages will also be presented during this session. There will also be one on one sessions where each provider interacts with us offering their feedback and asking any questions they might have regarding the changes. Administrative support is beneficial in order to implement the proposed changes and the clinic administrators should be willing to offer support and other resources if the change is to succeed (Aasekjær, Waehle, Ciliska, Nordtvedt, & Hjälmhult, 2016). Administrative support will be required especially for the budget and time resources required to ensure that the providers are able to undergo training on the new methods. The success of the project will be presented to the stakeholders during the initial meeting. This will assist them to understand how beneficial the change in practice is and demonstrate that there is evidence to support the need for change (Aarons, Ehrhart, Moullin, Torres, & Green, 2017; Wilson et al., 2015). The education plan for the providers will also be presented during this meeting. The plan will show how we plan to impart the requisite knowledge to the providers. The training will be mainly in house and supporting materials will be provided by the clinic. Using the WHO decision making tool tutorials will enable the training sessions to be short and interactive. This is vital to ensure that providers do not lose too much time learning a new method instead of attending to their clients. With the structured contraceptive counseling approach, the providers will be more involved and interactive with their clients, which would make the sessions more appealing and comfortable for the clients. This will result in the clients leaving with more knowledge and satisfied they have made the right decision.In conclusion, for the success of this proposed change it is vital that the other providers buy in to the changes. Without their input and buy in it will be difficult to implement the change. Therefore, the need to involve the stakeholders in the planning and change strategies is vital. When they understand there is a new change being proposed and they are involved before the change process begins they will be more willing to be part of the change. Having identified the key stakeholders and demonstrating to them how beneficial the change will be to the clinic and to the clients, the next step would be to implement the change. Implementation would begin with the education and training of the stakeholders in order to ensure that they understand how to carry out the counseling sessions. Following the conceptual model proposed will ensure that the providers are able to interact with the clients well and the clients will reciprocate the interaction by being more open and comfortable (Birgisson, Zhao, Secura, Madden, & Peipert, 2015). Involving the client in the decision-making process for their contraceptive will be vital and helpful in that the client is more likely to continue using the method since they feel it was not forced upon them by the provider......

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