Nursing Practice Initiatives
Despite their enormous and trusted role in health care, nurses are often unprepared to care for the woman with an unintended pregnancy who want to seek abortion. This leads to staffing shortages that prevent women’s access to abortion care, and a lost opportunity for nurses to serve as a trusted health resource for women seeking abortion. Little empirical research has been available to guide best practices and to improve access to quality nursing care throughout the continuum of pregnancy resolution. ANSIRH is currently working on a number of nursing-centered projects:
California Statewide Survey: Determining the capacity of the California nursing workforce to fully implement recent legislation (AB2348, AB980 & AB154) to expand access to primary and secondary prevention of unintended pregnancy
Recent legislation in California has implications for the expansion of nursing practice and a full evaluation of the existing nursing workforce is needed to determine nurses’ readiness to fully implement these expanded responsibilities. Specifically, registered nurses (RNs) gained autonomy in the initiation of hormonal contraception (primary unintended pregnancy prevention) and advanced practice clinicians (APCs) gained the ability to provide early aspiration abortion (secondary unintended pregnancy prevention). ANSIRH is currently collecting data from a representative, random sample of 2,500 RNs in California to determine their knowledge of these laws and self-assessment of confidence and competence to fully integrate unintended pregnancy prevention (primary and secondary) into their practices.
Developing Expert Nurses in Abortion Care
Building on previous work (McLemore, Levi & Kools, 2015; McLemore, James, Levi, 2015) designed to document the experiences of nurses who provide care to women seeking abortions in elective, emergent and urgent clinical situations, ANSIRH is conducting additional interviews with nurses from across the United States to continue to document the career trajectories of expert nurses in abortion care provision and to design career development activities for these nurses.
Procedural Sedation and Pain Management
Procedural sedation is an integral part of abortion care provision and pain management is a large component of nurses’ practice. ANSIRH is conducting two projects focusing on these clinical aspects of abortion care. First, as part of ANSIRH’s Abortion Facilities Standards Initiative, a comprehensive systematic review of procedural sedation in non-hospital settings for gynecologic procedures, including abortion, is being conducted with the UCSF Joanna Briggs Institute (JBI) Centre for Evidence-Based Patient & Family Care. Second, ANSIRH’s Monica McLemore is analyzing data from a retrospective chart review of 500 women who received procedural sedation for first and second trimester abortions. Manuscripts based on these data are being prepared.