Quality and Safety in Unintended Pregnancy Prevention and Care
In 2001, the Institute of Medicine (IOM) issued a landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, was produced by the Institute of Medicine (IOM) and articulated quality and safety problems with the U.S. health care system. A subsequent IOM report, Health Professions Education: A Bridge to Quality, presented a core set of competencies for health professions education. Using the IOM competencies, the Quality and Safety Education for Nurses (QSEN) Project defined quality and safety competencies for nursing and proposed targets for the knowledge, skills, and attitudes to be developed in nursing pre-licensure programs for each competency. The overall vision is for nurses to continuously improve the quality and safety of the healthcare systems in which they work.
How to Use This Module
This Nursing Education Curriculum is designed for a flipped classroom model to incorporate unintended pregnancy prevention and care into existing curricula.
Students—Click the student tab and complete the pre-assessment. You may have received a site code from your instructor which you may enter within the pre-assessment. Definitions and Orienting Facts provide context for the Patient Situations, which are clinical scenarios designed to raise critical issues and questions to put unintended pregnancy prevention and care in the context of public health. Students should complete the Required Reading at any time while going through the Patient Situations. Please complete the post-assessment after finishing the module.
Faculty—Open the faculty tab below to access teaching tips, exercises, and handouts for incorporating module content into the classroom, and to learn more about obtaining a “site code” to download and access students’ pre- and post-assessment data.
- Understand concepts of population health and integrate into the care of the individual patient.
- Understand the intersection of quality and safety and how it relates to unintended pregnancy prevention and care.
- Understand the unique challenges of providing sexual health information to people from different backgrounds.
- Analyze systemic barriers to family planning/pregnancy prevention for vulnerable populations.
- Develop skills in providing effective referrals for unintended pregnancy prevention and care health services.
Relevant UPPC Essential Competencies
Through a national Delphi study, Essential Competencies in Unintended Pregnancy Prevention and Care for Nursing Education (Hewitt, C. and Cappiello, J., 2015) 85 nursing experts in unintended pregnancy prevention and care reached consensus on 27 core educational competencies for nursing education which provide a framework for curricular development in an important area of nursing education. The following competencies are relevant to this nursing education module.
- Demonstrate ability to recognize unique reproductive health needs of women from vulnerable and special populations (e.g. adolescents, women with mental or physical disabilities, survivors of violence) affected by many factors (e.g. relationship status, sexual orientation).
- Demonstrate knowledge of current state-specific laws regulating minors’ access to reproductive care for the state(s) in which nurse practices (including contraceptive access and abortion care).
- Demonstrate knowledge of confidentiality regulations specific to unintended pregnancy prevention and care.
- Demonstrate understanding of how contraceptive methods work (e.g. hormonal methods, post‐partum and emergency contraception, lactational and fertility methods, IUD, barrier methods, sterilization), risks, benefits, alternatives, effectiveness, and eligibility.
- Demonstrate knowledge of current evidenced‐based guidelines for primary prevention of unintended pregnancy.
- Demonstrate proficiency in providing pregnancy test results in patient-centered manner.
- Demonstrate proficiency in obtaining a complete health history (inclusive of sexual and reproductive history, sexual orientation, partner preference, and appropriate to the developmental level of client).
- Demonstrate proficiency in referring clients with unintended pregnancy to area providers and support services.
- Demonstrate ability to participate effectively in interprofessional, team‐based care for unintended pregnancy prevention and care.
- Demonstrate proficiency in evaluating outcomes of plan of care and referrals for women with unintended pregnancies.
- Demonstrate ability to obtain or refer for appropriate laboratory tests specific to unintended pregnancy prevention and care.
Pre- and Post-Assessments
Definitions and Orienting Facts
Patient Situation 1
Patient Situation 2
This module addresses quality and safety in the context of unintended pregnancy prevention and care. Nurses work with patients in many different contexts, and providing safe, patient-centered care often means addressing a patient’s reproductive health concerns in addition to the primary reason the patient initially sought medical care. This gives nurses the unique opportunity to support patients in developing and achieving their reproductive life plan through patient-centered contraceptive management and options counseling.
These modules are designed to use with a flipped classroom model in which students are directed to complete the module as homework, including the Pre- and Post-Assessments. Once students have completed the module in its entirety, including the recommended reading, faculty can use the Teaching Tips document and materials from the Classroom Exercises section below to integrate concepts from the module into the classroom or group setting.
- Quality and Safety Patient Scenario
This handout from Provide describes a detailed patient scenario about Ana, a sexually active 17-year old who would like help managing her acne problems. The Teaching Tips document for this module provides guidance on facilitating classroom discussion related to the scenario.
- Contraception Counseling: Provider Tips and Patient Questions
This handout from CORE (Curricula Organizer for Reproductive Health Education) identifies specific questions for providers to consider and use when supporting patients in choosing a contraception method.
- Patient Education and Risk Reduction Messages
This exercise from CORE (Curricula Organizer for Reproductive Health Education) is designed for nursing faculty to use in class. The activity uses interactive case studies, role-play with scenarios, and group discussion questions.
- Sexual History Taking Role Play
This exercise from CORE (Curricula Organizer for Reproductive Health Education) is designed to help health care professionals improve their knowledge, skills, and comfort with sexual history taking and risk assessments. The worksheet includes questions to ask when taking a sexual history, specifically when working with LGBTQ patients.
- The Abortion Option: A Values Clarification Guide for Health Care Professionals
These exercises from the National Abortion Federation include tools that can be used in class for clarifying values related to abortion and discussing the role of health care providers.
- HOW to Refer
Use materials in Module 2 of Referrals for Unintended Pregnancy: A Curriculum for Health and Social Service Providers from Provide to present referrals as part of services provision, identify general barriers to accessing abortion care, and demonstrate best practices for referrals.
Accessing Student Pre- and Post-Assessment Data
Pre- and post-assessments are designed to measure students’ satisfaction with the module as well as what they have learned. To be able to complete the assessments students will need to enter a “site code” prior to working through the online module. Faculty will use this site code to download and review students’ pre- and post-assessment data. To obtain a site code your institution must e-mail AmyLevi@salud.unm.edu. In the text of the email, please include your name (as instructor), the name of the institution, and the module(s) for which you would like to access data. RhN will send you 1) a site code for your students to enter at the beginning of the assessment, 2) a web link to access the results from each module, and 3) an “answer key” to help grade your students’ responses. You may also assign a unique student code to each student that you would like to assess on an individual basis. Students must enter the correct site code for faculty to be able to access their data.