Effect of Nursing Management Protocol on IUDs Performance

• Main Authors: Iman Rashad, Sahar Naguib Mohammed, Shadia Abdel Qader Hassan, Maher Salah Mohammed, Heba Gamal Rashed
• Format: Article
• Language: English
• Published: Alexandria University 2007-03-01
• Series: Journal of High Institute of Public Health
• Subjects: nursing; management protocol; iuds; performance

Background: Intrauterine Devices (IUDs) remain an attractive birth-control option for many women who desire a highly effective form of birth control but cannot tolerate or do not want to use hormonal implants. However, fears about side effects, concerns about infection and infertility, lack of technical training for providers, and the time and costs involved in providing services combine to discourage their use. Objective: to assess the magnitude and types of problems associated with use of IUDS, and to examine the effect of a plan of nursing intervention on the performance of IUDs. Methods: The study was conducted in the Family planning outpatient clinic of Assiut University Hospital. A cross-sectional descriptive design, and a quasi-experimental research design with pre-post assessment were used. The assessment sample consisted of 409 women. The intervention group included 100 new IUD users who were randomly allocated into two equal groups of 50 women each. Subgroup A women received the intervention program without provision of prophylactic antibiotics, while subgroup B women received the program in addition to prophylactic antibiotics. The tools used for data collection were a structured interviewing questionnaire sheet for both the assessment and the intervention groups, and an examination form to record the clinical and laboratory findings of the intervention group. A follow-up sheet was used to record any possible complications one month after insertion. A pre-post-FU questionnaire form was used to assess women’s knowledge and misconceptions before and after the intervention. The study started at the beginning of April 2002 and ended in October 2003. Results: Only 17.6% of the women have reported no complications related to use of contraceptives. Vaginal bleeding and infection were the most common complications, 14.4% and 10.5%, respectively. The most common infection was Chlamydia (20.6%). Subgroup A women (no-prophylactic antibiotic) had a higher incidence of erythema and vaginal discharge at the follow-up vaginal examination, compared to pre-program rate, 34.0% and 10.0%, respectively (p=0.004). Also, women in subgroup A had a higher incidence of bacterial vaginosis (16.0%), compared those in subgroup B (4.0%), p=0.046. In subgroup B, positive chlamydial infection decreased from 34.0% at the pre-program exam to 10.0% at the FU (p