Easy Im Implementation of Medical Termination of Pregnancy In In Your Practice Step by Step NP Hannah Varto, MN, NP(F), SANE-A Embrace Clinic – Forensic Nursing Service Fraser Health
Speaker / Presenter Disclosure Hannah Varto I declare I have no relationship with commercial interests.
Barriers to Im Implementing MAs “I’m nervous I don’t know what I’m doing” “I heard you need an u/s first and I’m scared if I don’t have one” “It’s hard to do and follow up” “What if there are complications?” “I took the online training but there is so much to consider, I don’t know where to start” “What if the patient doesn’t follow up?”
Step by Step Assessment I developed a flow sheet to assist other clinics in understanding a process (and to clarify ours within our own clinic staff) Can be adapted for your own clinical workflow Principles: • Keep it simple! • Do not need an U/S as a standard • As few appointments as is necessary • As easy as possible for provider and patient • Clear education and consent
MOA MOA MOA
Clinician
Clinician Day 3 - 5: Clinician plans a phone call with the patient within 3 – 5 days of planned Step #1 - verifies pick up - no concerns, reviews experience, symptoms, ongoing symptoms Clinician - reminds about 7 day follow up lab work - reminds about contraception considerations - create a bring forward for day #8 Day 8: - verifies lab work was done, if no result, phone pt to remind - If labwork done, phones pt to discuss results - offers contraception start (ie. fax OCP Rx to pharmacy, book IUD insertion appt, etc)
Clinician
RhoGam • Have a process in place for pt to get this when needed • Review blood type as soon as results rec’d and book pt to come in as soon as possible for administration
Patient Education is Most Im Important Step of f MA!! • These appointments take about 30 mins • Need to book translator for any ESL issues • Simplify pt information as much as possible • Wish List: a video that visually shows how to take mife and what to expect (benefits low literacy, ESL, non-English speaking, hearing impaired, possible visually impaired) • The follow up phone calls are well received and tend to keep pt on track, they feel like they are cared for
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