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急诊科青少年避孕咨询:护士从业者和医师助理的新课程。

Contraceptive counseling for adolescents in the emergency department: A novel curriculum for nurse practitioners and physician assistants.

机构信息

Pediatric Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.

Department of Pediatrics, Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania.

出版信息

J Am Assoc Nurse Pract. 2023 Sep 1;35(9):540-549. doi: 10.1097/JXX.0000000000000824.

DOI:10.1097/JXX.0000000000000824
PMID:36735568
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10394106/
Abstract

Many adolescents use the emergency department (ED) as their primary source of health care. As a result, the ED serves as a unique opportunity to reach adolescents. Although many adolescent visits to the ED are related to reproductive health, ED providers report barriers to providing this care, including lack of training. Nurse practitioners (NPs) and physician assistants (PAs) serve a vital role in the provision of consistent care to adolescents in the ED. The purpose of this study was to create a curriculum to train NPs and PAs at two pediatric institutions to provide patient-centered contraceptive counseling to adolescents in the pediatric ED regardless of their chief complaint. To do this, we created a four-part webinar followed by an in-person training session. Participants completed training and then conducted counseling sessions with adolescents in the ED. Counseling sessions were recorded and reviewed for fidelity to delineated counseling principles, and data from post-counseling surveys were collected. 27 NPs and PAs completed the training and conducted 99 counseling sessions. Nearly all sessions incorporated essential content and communication principles such as shared decision making (90%) and teach-back methods (75%). All NPs and PAs who participated reported satisfaction and subjective improvement in knowledge and competence from the training. This curriculum offers a novel and feasible approach to train NPs and PAs to deliver patient-centered contraception counseling to adolescents in the ED setting, and it can serve as a model for how to educate different providers to incorporate reproductive health education into the busy ED visit.

摘要

许多青少年将急诊部 (ED) 作为他们主要的医疗保健来源。因此,ED 成为了一个独特的机会,可以接触到青少年。尽管许多青少年到 ED 的就诊与生殖健康有关,但 ED 提供者报告说,他们在提供这种护理方面存在障碍,包括缺乏培训。护士从业者 (NPs) 和医师助理 (PAs) 在 ED 为青少年提供一致的护理方面发挥着至关重要的作用。本研究的目的是为两家儿科机构的 NPs 和 PAs 创建一个课程,以在儿科 ED 为青少年提供以患者为中心的避孕咨询,无论他们的主要诉求是什么。为此,我们创建了一个由四部分组成的网络研讨会,随后是一个现场培训课程。参与者完成培训后,在 ED 为青少年进行咨询。对咨询进行了录音和审查,以评估其是否符合规定的咨询原则,并且收集了咨询后的调查数据。27 名 NPs 和 PAs 完成了培训并进行了 99 次咨询。几乎所有的咨询都包含了必要的内容和沟通原则,如共同决策 (90%) 和回授教学法 (75%)。所有参与的 NPs 和 PAs 都报告说,他们对培训的满意度和对知识和能力的主观提高感到满意。该课程为培训 NPs 和 PAs 提供了一种新颖且可行的方法,以在 ED 环境中为青少年提供以患者为中心的避孕咨询,并且可以作为如何教育不同提供者将生殖健康教育纳入繁忙的 ED 就诊的模型。

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