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Implementing a Standardized Competency Checklist for Intrauterine Device Placement

Date
2025-05
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DNP Project
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IUD COMPETENCY CHECKLIST
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Abstract

Problem & Purpose: Women of reproductive age who presented to an outpatient women’s health clinic (WHC) did not have access to timely appointments for intrauterine device (IUD) placement. This problem existed because only a limited number of advanced practice providers (APPs) at WHC were trained to insert IUDs. While IUD insertion is generally considered safe, complications such as uterine perforation, uterine expulsion, and difficult removal can occur, making it critical for providers to be properly trained. The purpose of this quality improvement (QI) project was to increase the number of skilled IUD placement practitioners at WHC by implementing and tracking the completion of a standardized education program and competency checklist, an evidence-based, research-supported practice change. Methods: A formal training and competency assessment program was implemented over a 15-week period in the Fall of 2024. All APPs that participated in the educational day were expected to subsequently complete the IUD competency assessment program, which consisted of two successful observations for APPs who have inserted IUDs at other practices (within the last three years) and five successful observations for new APPs. An evidence-based checklist developed by the University of California San Francisco Beyond the Pill Program was used for IUD competency evaluations. Results: Eight APPs completed the educational session and participated in at least two IUD competency evaluations. Four APPs completed all competency assessments and are now certified as independent placement practitioners. Of the 32 competency assessments completed, the percentage of skills deemed competent on each assessment ranged from 0% to 100%, with a median of 89%. Conclusion: Four out of the eight APPs at WHC were certified as independent placement practitioners by the end of the QI project. WHC sustained this project and by February 2025, all eight providers were certified. APPs participating in the program demonstrated an increased competence level as they progressed through each observed IUD placement. Having more trained APPs at WHC will allow patients easier access to IUD placement appointments and will ensure that APPs have the proper skills to ensure safe IUD placement.

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