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Npwh Position Statement: The Doctor Of Nursing Practice For Women's Health Nurse Practitioners [June 2020 Update], National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health (NPWH) supports a pragmatic approach to the continuing evolution of the Doctor of Nursing Practice (DNP) degree as entry level for Women's health nurse practitioners (WHNPs). During the transition, study of the impact of DNP education on quality, access, and cost of healthcare should be ongoing. Policies must be in place to ensure that currently practicing WHNPs are not disenfranchised from practice in any way. Furthermore, NPWH advocates for concerted strategies to maintain an adequate number of highly qualified WHNPs to meet the healthcare needs of individuals and communities.

Depression Screening In Antepartum Females, Michelle Burk

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Problem Statement: Perinatal mood disorders, including depression, affects one in five pregnant or postpartum females. The American College of Obstetricians and Gynecologists (ACOG) and the US Preventative Task Force (USPTF) recommended screening for depression at least once during the antepartum and postpartum periods. The purpose of this quality improvement initiative was to introduce depression screening using the patient health questionnaire (PHQ) in antepartum women in a Midwestern private OB-GYN practice.

Methods: An observational, descriptive, cohort design utilizing a retrospective record review was used to evaluate for PHQ depression screening. A convenience sample of antepartum patients at/or around 36-weeks gestation was …

Non-Delayed Access: Establishing A Same Day Walk-In Contraception Clinic For Active Duty Women And Military Spouses, Ludrena C. Rodriguez, Callie M. Cheese, Luiz F. Correa

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: The overall goal of the quality improvement initiative is to explore the feasibility of removing access barriers for contraception in active duty service members and their beneficiaries in an Army gynecology clinic.

Summary: A multidisciplinary team developed and implemented a same day walk-in contraception clinic with the intent to offer services one day per week with one healthcare provider and medical assistant allotted for staffing. The team utilized an individualized approach by screening patients for risk factors reflected in the medical eligibility criteria. Patients completed a user-friendly triage form and submitted a urine sample awarding the providers reasonable certainty …

Npwh Position Statement: Climate Change, Women's Health, And Environmental Justice, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health (NPWH) asserts that climate change has a significant effect on health and wellbeing globally. NPWH believes that nursing organizations and the nursing profession have a responsibility to meaningfully contribute to reducing vulnerability to the harmful effects of climate change (adaptation) and reducing or preventing greenhouse gas (GHG) emissions (mitigation) for the protection of the health and wellbeing of individuals, communities, and populations. NPWH recognizes that social and environmental justice are inherently connected to reducing harms to health and wellbeing associated with climate change. NPWH advocates for global and national policies and …

Factors Influencing Breastfeeding Duration And Cessation Among U.S. Military Personnel: A Descriptive/Exploratory Electronic Survey, Dana Brown, Lisa Wetmore Locasto, Thomas W. Cline

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: The primary aim of this study is to address the national public health issue of breastfeeding initiation and sustainment in relation to evidence-based practice recommendations by identifying factors associated with the duration/cessation of breastfeeding in U.S. military settings. Â

Methodology: A convenience sample of 615 participants was recruited with the use of social media pages and email invitations from the researcher, military affiliated breastfeeding support groups, and university veteran groups. Inclusion criteria were (a) current or prior service in U.S. military, (b) current or prior breastfeeding experience during service term, and (c) breastfed or pumped milk for a child …

Barriers To Inquiry About History Of Sexual Assault During Initial Assessment, Leigh Minchew, Terrie Platt, Candice N. Selwyn, Emma Lathan

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

History of sexual violence is a pertinent concern when providing comprehensive nursing care. One in three women and one in four men experience sexual violence within their lifetime, leading to a host of adverse health outcomes (CDC, 2020). The American College of Obstetricians and Gynecologists (2019) recommends sexual assault screening for all women using a trauma-informed care (TIC) approach. Yet, patients' histories of sexual violence may be overlooked by healthcare providers. Principles of TIC practice have been shown to promote healing (Machtinger et al., 2019). As provider comfort with history of sexual violence inquiry may depend upon previous education (Lewis-O'Connor …

Npwh Position Statement: Whnps As Partners In Addressing The Maternal Health Crisis, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

There is a well-recognized maternal health crisis in the United States. In 2020, 861 women* died of pregnancy-related complications. This rate remains higher than that of any other resource-rich country. Alarming disparities exist, with non-Hispanic Black women and American Indian/Alaska Native (AI/AN) women having significantly higher pregnancy-related mortality rates than non-Hispanic White women. Severe maternal morbidity (SMM) is part of this maternal health crisis. As with pregnancy-related deaths, rates of SMM are increasing and racial and ethnic disparities continue.

*The terms women, people, and individuals are used interchangeably in this position statement with the recognition that people who are able …

Initiative To Improve Osteoporosis Management By Adapting The Fracture Liaison Service For Outpatient Use, Tiffany Messerall, Callie M. Cheese, Sarah King

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: To evaluate whether the implementation of the IOF Best Practice Framework in an outpatient women's health clinic results in improved identification and management of post- menopausal women at risk of an osteoporotic fracture.

Summary: Fragility fractures in post-menopausal women are more common than stroke, myocardial infarction, and breast cancer combined. An osteoporotic fracture has a large impact on quality of life, the risk for subsequent fractures, and the risk of mortality. The number of fragility fractures are expected to increase as a result of the growing and aging population. However, despite known diagnostic and management modalities only 20% of …

Obstetrical Healthcare Providers' Knowledge Of The 2009 Iom Guidelines For Weight Gain In Pregnancy; Clinical Integration And Implications, Beth Steinfeld

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: More than 35.8% of the US population is obese; 45% of pregnant women are overweight and thus, are at risk for numerous negative perinatal outcomes. Healthcare providers are faced with the challenges of having adequate educational preparation to help obese clients limit weight gain to comply with the recommended amount of gestational weight. Consistent integration of weight management interventions into their practice with obese clients will help address this clinical dilemma. In response to this problem, in 2009, the IOM reexamined their guidelines for weight gain in pregnancy and issued new and more stringent guidelines for weight gain for …

Use Of A Standardized Education Tool To Increase Patient Selection Of Highly Effective Contraception, Julee Avram, Denise G. Link

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: The purpose of this project was to increase patient acceptance of LARC through the use of a standardized educational tool that has been demonstrated to be effective in assisting women to make informed decisions when choosing from among the most reliable and effective contraception methods available to them.

Summary: The Centers for Disease Control and Prevention recommend that all women use highly effective contraceptive methods, such as LARC to reduce unintended pregnancy. Research has demonstrated that standardized approaches to counseling are the most effective at increasing LARC use. In a small, private OB-GYN practice with one physician and two …

Npwh Position Statement: Primary Prevention Of Cardiovascular Disease In Women, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health (NPWH) affirms that women's health nurse practitioners and other advanced practice registered nurses who provide healthcare for women across the lifespan have a critical role in cardiovascular disease (CVD) risk screening and implementation of primary prevention strategies to improve the cardiovascular health of women. NPWH promotes a person-centered cardiovascular health approach based on currently recognized guidelines, appropriate use of risk assessment tools, attention to social determinants of health (SDOH), and shared decision making about best strategies to reduce CVD risk. A multidisciplinary health professional team-based approach has the potential to improve …

Patient Acceptance Of Decreased Cervical Cancer Screening Frequency In An Urban Practice, Meredith Hudes-Lowder, Elizabeth Cole Collins

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: To examine women's preferences for cervical cancer screening frequency in a large, multiethnic urban medical practice

Methodology: A descriptive, cross-sectional survey design was used. A convenience sample of women aged 33 to 60 (n = 250) completed a survey regarding cervical cancer risk and screening perceptions at a gynecologic visit. Information collected included the participant's current Pap frequency, opinion regarding appropriate Pap test intervals, and perceived risk of being personally diagnosed with cervical cancer. Descriptive statistics and bivariate analyses were used to characterize the sample and examine associations between variables.

Results: Mean age was 44.1 years (SD = 8.4). …

Reproductive Outcomes After Cyclophosphamide Treatment Of Adolescents With Systemic Lupus Erythematosus: A Retrospective Review, Jennifer Kurkowski, Jane Geyer, Jennifer Bercaw-Pratt, Marietta Deguzman, Martha Curry

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: To review women younger than 21 who received cyclophosphamide and the effects on reproductive health

Methodology: A retrospective chart review is in progress (data collection phase). Descriptive statistics will be utilized.

Results: All results are not currently available as this is a study in progress but will be available at the NPWH conference. We felt this study is important as systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects women of reproductive age. Cyclophosphamide (CYC) can have long term effects on menstruation and fertility. There have been few studies looking at the reproductive health of women younger …

Npwh Position Statement: Marijuana Use During Pregnancy And Lactation, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health (NPWH) advocates for a nonjudgmental and evidence-based approach to screening and counseling women concerning marijuana use during pregnancy and lactation. NPWH supports strategies to educate the public about safety concerns and to reduce marijuana use during pregnancy and lactation. Legislation, policies, and clinical processes should ensure that women who use marijuana have access to nonjudgmental, nonpunitive, person-centered healthcare throughout pregnancy, birth, and the postpartum period. NPWH supports ongoing research on the effects of marijuana use on fetal and neonatal outcomes, long-term effects on neurodevelopment, and safety of use during breastfeeding.

Promoting Adherence To Care For Women Diagnosed With Gestational Diabetes Mellitus, Joan Pirog

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Improve adherence to care by providing patient teaching for women diagnosed with GDM in the clinic setting.

Summary: Participants were enrolled once diagnosed with GDM, consent was obtained. The Diabetes Knowledge Survey for Gestational Diabetes was administered. Ongoing education was provided every 1-2 weeks in the clinic setting. Effectiveness of education was assessed using a post-test at 39 weeks' gestation with a goal of achieving a 20-point increase. The participants' perception of their risk of developing DM later in life and their perception to implement change to prevent the onset of DM was assessed by the Risk Perception Survey for …

Maternal Mortality And Failure To Rescue: Implications For Women's Health Practitioners, Peggy J. Mancuso, Elizabeth B. Restrepo, Fuqin Liu, Patti Hamilton

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: To analyze publicly available data to evaluate the recent prevalence of maternal mortality in Texas and map locations with high maternal mortality. Through expansion of the concept of failure to rescue (FTR), a public health approach to maternal mortality was applied that incorporated drug overdose, homicide, and suicide. These three previously overlooked causes of mortality often occur after the 42-day postpartum period.

Methodology: Using a descriptive, epidemiological, and cohort design, we analyzed birth and death certificate data for Texas, 2013 through 2015. We applied the formula for FTR used by the National Quality Measures Clearinghouse and expanded the definition …

Third Trimester Screening For Chlamydia And Gonorrhea In Pregnant Teens, Shauna Smith, Jennifer Allen, Debra Ilchak

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: The purpose of this project was to implement a practice change in a clinic caring for underserved pregnant teens to align with national standard of care guidelines from the Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force (USPSTF), which recommends routine third trimester chlamydia and gonorrhea screening in high risk populations.

Summary: Despite national recommendations, providers are under screening and missing opportunities to screen young, at risk women, especially in pregnancy. Only an estimated 59% of pregnant women in the United States (U.S.) are receiving chlamydia and gonorrhea screening (Blatt el al., …

Npwh Position Statement: Male Sexual And Reproductive Health: The Role Of Whnps, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health affirms the right of all individuals to quality, evidence-based sexual and reproductive health (SRH) care that is non-judgmental, respectful, and culturally appropriate. SRH is an important component in individuals' overall physical, emotional, and social well-being. SRH encompasses sexuality, sexual relationships, and all matters related to the function and processes of the reproductive system. The SRH of one individual often intertwines with that of another individual or individuals. Sexual and reproductive healthcare includes health promotion, disease prevention, and identification and treatment of disease. As such, SRH care addresses issues such as sexuality, …

Npwh Position Statement: Prevention And Management Of Opioid Misuse And Opioid Use Disorder Among Women Across The Lifespan, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health (NPWH) position statement on prevention and management of opioid misuse and opioid use disorder (OUD) among women across the lifespan was approved by the Board of Directors December, 2016. NPWH supports the role of nurse practitioners who provide healthcare for women across the lifespan in the provision of safe and effective treatment of pain. In certain cases, this treatment may include the prescription of opioid pain relievers (OPR). NPWH acknowledges that nurse practitioners must use evidence-based strategies to reduce harm from the misuse of OPR and to prevent the development of …

Npwh Position Statement: Systemic Racism And Implicit Bias In Women's Healthcare, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health (NPWH) is committed to addressing structural racism and implicit bias in meaningful ways that will improve Women's healthcare and reduce health disparities. Structural racism encompasses the ways a society fosters racial/ethnic discrimination through intersecting and reinforcing systems. Structural racism creates differential access to opportunities by race/ethnicity and perpetuates inequities among these groups. Implicit bias derives from an individual’s learned stereotypes and prejudices that automatically and unconsciously influence affect, behavior, and cognitive processes. Implicit bias affects patient–clinician interactions, treatment decisions, treatment adherence, and patient outcomes. Implicit bias in the healthcare setting and …

Women Living In Crisis Areas Of Sub-Saharan Africa's Use Of Family Planning: A Review Of The Literature, Kelly Ackerson, Ruth Zielinski

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: Explore available research and summarize factors that inhibit or promote family planning and contraceptive use among refugee women and women from surrounding areas living in Sub-Saharan Africa. Too many women continue to die from pregnancy and childbirth related causes. While rates have decreased over the past two decades, maternal mortality remains very high in Sub-Saharan Africa. Family planning and use of modern contraceptives decrease maternal mortality, yet rates of use in Sub-Saharan countries with the highest rates of maternal death remain very low.

Methodology: A review of the literature published between 2006 and 2016 was conducted using Cochrane Library, …

Improving Knowledge, Skills, And Attitudes About Breastfeeding, Vaidehi Patel

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: The purpose of this DNP project was to work in collaboration with the Women's Health Center at a local hospital to implement a breastfeeding education intervention among the staff, for the ultimate goal of improving breastfeeding knowledge, skills, and attitudes.

Summary: The various health benefits of exclusive breastfeeding are widely known. Various study sources, including professional peer-reviewed literature have demonstrated that breastfeeding is the optimal form of feeding and is considered a gold standard for infant nutrition. The purpose of DNP project was to work in collaboration with the Women's Health Center at a local hospital to implement a …

A Quality Improvement Initiative: Patient-Centered Intimate Partner Violence Screening, Brief Intervention, And Referral To Treatment, Angela Price, Kimberly Couch

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Background: One in 4 women will experience some form of violence by a partner in her life. IPV affects 6.5 million women in the United States a year with a price tag of $8.3 billion annually. An average of three women are murdered by their partners a day as a result of this abuse.

Local Problem: IPV screening was not the standard of care at a private suburban obstetrics and gynecologic office. A total of 664 women, 83% Caucasian with private health insurance ranging in age from 13 to 65 participated in this QI initiative. The aim of this project …

Enhanced Substance Use Screening In The Prenatal Clinic, Jesse Oman, Leigh Minchew

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Increasing prevalence of substance use among pregnant women exists in the U.S. During pregnancy, screening may identify substance use earlier in order to initiate interventions that impact the lives of mothers and their unborn children. This study investigates the use of a screening tool's effectiveness in identifying women affected by antenatal substance use to provide for early treatment and referral. The American Congress of Obstetrics and Gynecology (ACOG) recommends screening every pregnant woman for substance use as part of a thorough obstetrical history.1 ACOG also supports the use of the 4Ps Tool, a valid and reliable instrument used to identify …

Implementation Of A Universal Screening Program To Increase Identification And Treatment Of Perinatal Mood And Anxiety Disorders Among Pregnant And Postpartum Women, Laura Bartlett, Terrie Platt

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: The purpose of this project is to evaluate whether the consistent implementation of a valid and reliable screening tool for perinatal mood and anxiety disorders in the clinic setting, as well as follow-up care, will result in better identification and treatment.

Summary: From January-May 2017, clinicians at the OB/GYN clinic implemented use of the Edinburgh Postnatal Depression Scale (EPDS) to screen patients for perinatal mood and anxiety disorders at the initial obstetric visit, 24 week visit, 36 week visit, 2 week postpartum visit (if applicable), and 6 week postpartum visit. With EPDS scores of ≥10, the clinician performed risk …

Promoting The Use Of Aromatherapy To Decrease Anxiety And Patient Perception Of Pain During A Gynecologic Procedure: An Integrative Therapy Quality Improvement Intervention, Christine Ellison, Diana Drake

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The purpose of this study was to implement a system for clinic staff and providers to promote, support, and document the use of lavender aromatherapy to reduce anxiety and pain perception as an option for patients experiencing an intrauterine device insertion.

This QI project will take place at a gynecology clinic within a large midwestern tertiary healthcare center. Patients presenting to this clinic site are seen throughout the lifespan for a variety of women's health conditions. The implementation of this QI project will provide women with an option of using an integrative therapy to help reduce anxiety and perception of …

Npwh Position Statement: Brain Health Is Women's Health, National Association Of Nurse Practitioners In Women's Health

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

The National Association of Nurse Practitioners in Women's Health (NPWH) supports collaborative action to establish brain health as a crucial aspect of Women's healthcare. A comprehensive approach includes promoting brain health, detecting cognitive impairment (CI) to facilitate accurate diagnosis and early intervention, and identifying and addressing the needs of individuals who are caregivers for loved ones with CI. NPWH believes a need exists for extensive research to better understand modifiable factors that influence brain health, improve one’s ability to make an early diagnosis of CI, establish effective therapies to prevent and treat CI, and support families and caregivers of individuals …

Physical Activity Trends Among Minority Women, Amber Vermeesch, Wanda M. Williams, Lola Maclean

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: To present and analyze physical activity participation trends, prevalence, and areas of strategic development among minority (Black and Latina) women.

Methodology: Secondary analysis of data from the National Health Interview Survey 2008-2014 was explored to assess prevalence of physical activity among minority women (Black women N=23,162, Latina women N=37,103). The aim of this study is to examine trends and correlates physical activity participation. The information is important for the development of strategies to promote physical activity participation in minority women. The social ecological model will be the guiding framework for this study, which considers a multilevel approach to understanding …

Sexually Transmitted Infections And Vaginitis Screening In Urgent Care, Robyn Fuller

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Purpose: The purpose of this quality improvement project was to use a web-based education to standardize STI and vaginitis screening methods, in adolescent and adult women presenting to the urgent care setting. The aim was to change clinicians' current beliefs and practices, for vaginitis and STI screening methods, to reflect current evidence-based practice, with an emphasis on self-collected vaginal swabs (SCVS).

Summary: Project participants included clinicians currently practicing in the urgent care setting and licensed as either a physician, advanced registered nurse practitioner, or physician assistant. An email inviting participants to participant in the e-learning module was sent to 34 …

Implementation And Evaluation Of A Mindfulness-Based Intervention For Patients Undergoing In Vitro Fertilization, Susan Marfoglio, Elizabeth Collins

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

One in every four couples worldwide will experience infertility and almost 60% of those will report psychological distress related to diagnosis or treatment. The purpose of this evidence-based practice project was to evaluate feasibility of incorporating a brief mindfulness-based intervention into usual care at an infertility practice. Effectiveness of the intervention in reducing anxiety and depression in patients undergoing in vitro fertilization was evaluated.

Summary: Participants (n = 15) were recruited from a university-affiliated infertility practice. Mindfulness training was provided in two-hour group sessions once weekly for four weeks. The meetings were conducted via Microsoft Teams during the COVID-19 pandemic. …