Ways to Improve Contraception Counseling

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Proper contraception usage is one of the most important factors towards improving patient outcomes in the obstetrics and gynecology setting. The search of evidence in existing literature has demonstrated that contraception use differs among patient populations while there is a strong link between education and proper contraception use (Gosavi et al., 2016). The existing evidence has also shown that healthcare providers in the obstetrics and gynecology setting utilize various teaching tools to provide education to patients on contraception use. The teaching tools range from verbal education to visual education like cue cards and pamphlets for patients to take home and further reinforce information communicated in the clinic (Lee, 2014). However, there is need for additional materials and strategies for patients to understand proper contraception use. In essence, while the use of various teaching tools helps in enhancing patients’ knowledge, proper contraception usage requires the use of better strategies. Such strategies would help in meeting the need for additional materials and methods to promote proper usage of contraception.

Strategies to Move Evidence-based Recommendations into Practice

The search for literature has provided evidence-based recommendations that should be moved into clinical practice in order to promote proper contraception use among patients in the obstetrics and gynecology setting. According to a publication by Australia’s National Health and Medical Research Council (2000), there are various implementation and dissemination strategies for putting evidence-based recommendations into clinical practice. These strategies include conducting educational outreach visits, multifaceted interventions, mass media campaigns, interactive educational meetings, and administrative interventions. These implementation and dissemination strategies are utilized through formulating a program that focuses on promoting the use of evidence-based recommendations in clinical practice.

For this study, the researcher will develop a program that seeks to enhance patients’ knowledge on contraception usage. This program will be centered on multifaceted interventions, which are needed to promote the use of research evidence in administrative and clinical decision making in different healthcare settings (Titler, 2008). The program will be developed and implemented as a project in an outpatient obstetric and gynecology clinic. The use of an outpatient clinic for this project provides a suitable environment for promoting enhanced contraception knowledge and usage within and outside the hospital. The project will be designed as a multifaceted intervention strategy since such a strategy has been found to be more effective in the clinical setting than single intervention strategies. Grimshaw et al. (2006) contends that multifaceted interventions are more effective than single interventions with respect to moving evidence-based recommendations into clinical practice. This is primarily because multifaceted interventions address clinical practice based on the individual practitioner, patient population, and organizational perspective.

The project, which will provide the basis for translating evidence-based recommendations into practice, will be carried out through a series of steps. The first step will entail selecting a practice topic, which is usually the first step in translating evidence-based research into clinical practice (Titler, 2008). This step was carried out in the first parts of this assignment in which the researcher identified the issue of contraception usage among Chinese/Cantonese-speaking women in outpatient obstetric and gynecology clinic. This is followed by evaluating and synthesizing existing evidence on the research issue, which was also carried out in the previous segments of this DNP project. The third step will involve designing a program/project that focuses on using evidence-based recommendations to guide clinical practice. The project will primarily focus on determining the effectiveness of The Balanced Counseling Strategy in enhancing contraception knowledge among this patient population as compared to routine contraception counseling. Therefore, the researcher will utilize two interventions in the study i.e. The Balanced Counseling Strategy and routine counseling strategy. Once the project is implemented, it will be evaluated in terms of the impact of evidence-based recommendations on clinical practice. This evaluation will focus on examining how the project affects provider performance as well as patient care and outcomes. The evaluation will also involve assessment of the setting or context in which this clinical practice was implemented.

The use of these various steps as part of the multifaceted intervention strategy for translating evidence-based recommendations into clinical practice is attributable to the fact that they promote learning in each stage of the process. Titler (2008) states that the learning that takes place in each of these steps and process provide valuable insights for capturing and providing feedback into the process.

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These valuable insights are captured to help other clinicians in relatively similar settings to adapt the evidence-based recommendations and/or implementation strategies in their clinical practice. This essentially means that the project will act as a foundation through which clinicians in other settings could adapt evidence-based recommendations and/or the implementation strategies to transform clinical practice.

This pilot project could then be utilized as the premise for administrative interventions, which is also a strategy that can be utilized to move evidence-based recommendations into practice. Administrative interventions basically entail healthcare decision making to change clinical practice (National Health and Medical Research Council, 2000). In this regard, necessary administrative steps are undertaken including removing barriers to implementation of evidence-based recommendations and promoting change in behavior among clinicians to support the process. These interventions will act as a premise for ensuring continuity in the translation of evidence-based recommendations into clinical practice. Through this process, the validity of decisions made earlier is considered and the need for any further changes is identified and implemented to support evidence-based practice (Kulier, Gee & Khan, 2008).

Changing Clinical Practice

This project will focus on promoting changes in clinical practice in order to enhance contraception use among Chinese/Cantonese-speaking women in an obstetric and gynecology outpatient setting. Based on the insights obtained from evaluation of existing evidence, the researcher will develop a project that seeks to promote changes in contraception education in the clinical setting. Through this project, the researcher seeks to identify the most effective method for improving patients’ knowledge and use of contraception. The identification of the most effective educational strategy will help in changing clinical practice with respect to patients’ contraception knowledge and use. The identified method for enhancing patients’ knowledge and use of contraception will be based on evidence-based recommendations.

In this regard, the researcher will conduct a quantitative pre-test, posttest study that will examine the effectiveness of structured contraception counseling in improving patients’ knowledge and use of contraception in comparison to routine contraception counseling. Therefore, structured contraception counseling is the main concept of interest in this project since the current routine contraception counseling is relatively ineffective in enhancing patients’ knowledge and use of contraception. The quantitative pre-test, posttest study will be conducted on a group of child-bearing women who speak Chinese or Cantonese and receive gynecological services at a private obstetrics/gynecology outpatient clinic. The researcher has identified a private Obstetrics and Gynecology (OB/GYN) outpatient clinic that is an ideal setting for the project. This private clinic currently utilizes routine contraception counseling in which child bearing women at the facility receive verbal education on contraception use and are also given pamphlets and cue cards as visual education tools to be used at home. While there are no language or cultural barriers within this homogenous population of staff and patients, patients experience difficulties in retaining what they learn from the contraception education tools.

When conducting this study, The Balanced Counseling Strategy (BCS) will be utilized as the structured contraception counseling. The BCS toolkit incorporates international family planning norms and guidance as recommended by the World Health Organization (WHO), including the 2004 Medical Eligibility Criteria for Contraceptive Use and the 2007 Family Planning Global Handbook (Population Council, 2007). The main focus will be on the counseling cards to help explain to patients the various methods of contraception and to provide an added opportunity for reinforcement of information. Patients can take the brochures and pamphlets home with them.

The use of a quantitative pretest-posttest research design for this project is attributable to the fact that this research methodology is suitable when comparing groups and/or measuring changes emanating from experimental treatments (Dimitrov & Rumhill, 2003). Allesandri, Zuffiano & Perinelli (2017) state that a pretest-posttest research design is appropriate for evaluating the effectiveness of intervention programs utilized in the clinical setting. Since this research seeks to examine the effectiveness of BCS as a structured contraception counseling vis-à-vis routine methods, a pretest-posttest research design is the most suitable research methodology for the project.

When conducting the project, the researcher will divide the participants into two groups i.e. an experimental group and a control group. This implies that a two groups, pretest-posttest research approach will be utilized in this project. The participants will be….....

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