Timing of LARC Insertion in Resident Physicians vs. Nurse Practitioners at an Urban Teaching Facility [11G]. (May 2018)

• Record Type: Journal Article
• Authors: Cortez, Sarah; Runyan, Aliye; Roberts, LeAnne; Recanati, Maurice; Dai, Jing
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533361.94363.94
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: To examine the time interval between request and placement of long-acting reversible contraceptives (LARC) by residents vs. nurse practitioners at an urban teaching facility. METHODS: Retrospective electronic health record review of all patients who received LARC devices in 2016 at the University Health Center Ob/Gyn staff clinic in Detroit, MI. Data was analyzed using descriptive statistics and student's t -test for comparison of means. RESULTS: Between January 1 and December 31, 2016, 311 patients received intrauterine devices (IUD) or subdermal implants (SDI). Of patients desiring LARC, 24% did not receive their contraceptive device same-day. Average interval between IUD request and placement, for those not receiving same-day contraception, was similar in nurse practitioner (1.2 months) vs. resident clinic (1.0 months). Average interval between SDI request and placement in nurse practitioner (1.3 months) vs. resident clinic (0.5 months) was statistically significant (95% CI, 0.4 to 1.2, p=0.0002). The only cited reason for interval delay of SDI placement was "no available trained provider". CONCLUSION: The majority of patients at University Health Center did receive same-day LARC placement, however, many patients required multiple visits between expressed interest of LARC and placement of the contraceptive device. Interval timing, for IUD placement, did not differ in resident vs. nurse practitioner clinic; however interval timing of SDI placement was affected by a reduced number of available trained providers in the nurse practitioner group. ACOG recommends same-day LARC placement, therefore increasing SDI placement training or increasing the availability of SDI trained providers is an identified area of improvement for our clinics.