Advanced Practice Registered Nurses and Long-Acting Reversible Contraception

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Abstract

Introduction:

Advanced practice registered nurses (APRNs) are in an excellent position to address the high rates of unintended pregnancy in the United States by providing long-acting reversible contraceptives (LARCs). These methods are significant in their effectiveness in preventing pregnancy in individual women and in having population-level effects on unintended pregnancy. The aim of this study was to learn more about APRN practices around long-acting reversible contraception and influences on those practices.

Methods:

A cross-sectional survey of APRNs who provide women's health services was conducted during the summer of 2015 using an existing adapted instrument with items on personal and patient characteristics, opinions, practices, and training around LARC methods. Zero-inflated Poisson regression models were conducted to study the factors that influenced the number of LARC insertions in the past year.

Results:

While 84% of the 390 respondents were inserting intrauterine devices (IUDs) and 77% single-rod implants, only 16% of these were inserting more devices than 5 years earlier. The most significant predictor of placement of these contraceptives was the clinical practice of requiring only one visit for completion.

Discussion:

National guidelines and recommendations have been in place for several years stating that women should be able to receive the contraceptive method of their choice in just one clinic visit. Women's access to LARCs from APRNs may be less than optimal. Additional research is needed to understand if the limitations in accessibility of this important reproductive health service are a function of clinician practices or clinic policies.

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