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Improving IUD Usage Among Adolescents Through Provider Educa?on

Sophie Griswold (BSN Student), Lisa Kiser CNM WHNP (Faculty Mentor), Melissa Goldsmith PhD RNC (Faculty Mentor), Ka7e Strawn RN BSN (Faculty Mentor)

Purpose Review of Literature Proposed Best Prac?ce

To propose changes that can be made to the curriculum for nurse Eight ar7cles were reviewed for this paper. Create a guide for nurse prac77oner schools about how to create training
prac77oner programs or con7nuing educa7on courses to improve
IUDs are eec7ve at preven7ng pregnancy modules for new nurse prac77oners about IUDs. The purpose of these
provider understanding of the use of intrauterine devices (IUDs) in young
women and adolescents. levonorgestrel IUD has a cumula7ve ve-year guidelines is to challenge misconcep7ons surrounding the use of IUDs in
Present and synthesize research in the safety, ecacy, and proper use of pregnancy rate of less than 0.5% young women, namely that they are unsafe, o_en discon7nued, or
IUDs in adolescent popula7ons copper IUD has a cumula7ve ve-year pregnancy otherwise inappropriate for younger pa7ents. Use a combina7on of skills
rate between 0.3% and 0.6% (Thonneau & Almont, and didac7c training.
2008)
Only 12% of primary care NPs and 66% of womens health NPs (WHNPs) Main points of educa7on guidelines:
had received clinical IUD inser7on training (Harper et al., 2013) If given the choice, adolescents prefer LARCs
IUD users ages 14-19 reported a sa7sfac7on rate of 76%, whereas users
Young women with IUDs are sa7sed with their method of
of non-LARC methods in the same age range reported a sa7sfac7on rate
of 42%. They also had signicantly lower rates of discon7nua7on as contracep7on
compared to their peers who chose non-LARC methods. (Rosenstock et IUDs are safe for use in adolescents and do not increase
al., 2012) incidence of PID or infer7lity
Background Nurse prac77oners cited several barriers to IUD provision: lack of
Lack of clinician skill, condence, training, and clinician bias
clinician training and condence, misconcep7ons that IUDs are not
The United States has a higher rate of unintended pregnancy than most of are major barriers to the use of IUDs in adolescents
appropriate for younger users or users with more than one partner,
the industrialized world (Daley, 2014) IUDs are an eec7ve method of preven7ng pregnancy in
misconcep7on that there is a need for mul7ple clinic visits (Gilmore et
About 50% of all pregnancies that are conceived each year in the United
States are unplanned al., 2015) (Kavanaugh et al., 2013). adolescents as compared to other methods
Teenagers have the highest rates of unintended pregnancy of all sexually The risk of PID increases only in the rst 20 days a_er inser7on, a_er Lack of knowledge about IUDs among young women
ac7ve age groups (Kavanaugh et al., 2013) which it returns to baseline (Carr & Espey, 2013).
82% of teen pregnancies in the US are unintended necessitates in-oce educa7on by providers
Many teen mothers report not using contracep7on at the 7me of Providing clinics with training increases the number of women who
choose IUDs and also decreases the rate of unintended pregnancy
IUDs should be one of the rst line forms of contracep7on
concep7on
Most teenagers use oral contracep7ves or condoms- both have high failure during the subsequent 12 months (Harper et al., 2015). considered for adolescents
rates and rely on user adherence
The WHO recommends IUDs as rst-line contracep7ves for adolescents
Many providers do not oer them to adolescent pa7ents because they are
not condent in their skills or were taught outdated informa7on

Please contact Sophie Griswold for full reference list