Sexual and Reproductive Health Content in the 3 Ps in Nurse Practitioner Education.

BACKGROUND: Nurse practitioners (NPs) in primary care provide sexual and reproductive health care, an integral component of health and well-being. This study explored the degree of inclusion of sexual and reproductive health content in the foundational courses in NP preparation including advanced health assessment, advanced physiology and pathophysiology, and advanced pharmacology, known as the 3 Ps. METHOD: Qualitative interviews were conducted with 30 NPs in their first 2 years of practice. RESULTS: Sexual and reproductive health content was well integrated into advanced assessment courses, although participants wanted more comfort and skill with discussing sensitive sexual health issues. Advanced pharmacology and advanced pathophysiology courses were not likely to include the content. CONCLUSION: Interactive learning opportunities, such as simulation with feedback, promote communication skills with sensitive health issues. Foundational courses would benefit from a deeper understanding of the menstrual cycle, sexual functioning, and medications specific to sexual and reproductive health. [J Nurs Educ. 2022;61(3):131-136.].

The key to successful NP transition to practice.

ABSTRACT: This article explores the experiences of the new NP's onboarding process based on data from two qualitative studies. Interviews with 27 new graduates were used to inform the design, implementation, and experience of an onboarding program in a small healthcare setting without robust internal resources or a human resource department.

Did I learn enough to practice? Reflections of new nurse practitioner graduates in providing sexual and reproductive health care.

BACKGROUND: The Centers for Disease Control and Prevention and the US Office of Population Health have published guidelines for providing family planning services. PURPOSE: The study explores how nurse practitioners (NPs) perceived their preparation and competency in providing a range of sexual and reproductive health care in their first two years of community-based practice. METHODOLOGICAL ORIENTATION: Qualitative. Thematic analysis used to analyze data from structured and open-ended interview questions. SAMPLE: Through snowballing recruitment, 35 NPs participated in interviews. CONCLUSIONS: Participants were most confident and likely to provide contraceptive and sexually transmitted infection services. Participants felt less prepared to provide male sexual health and care to the lesbian, gay, bisexual, transgender, queer, and intersex+ population. Nurse practitioners expressed interest in building skills with discussing healthy sexuality across the life span, specifically postmenopausal sexual concerns, teen sexuality, trauma-informed care related to sexual violence, and early pregnancy decision making. Some participants had little preparation in early pregnancy decision making/options counseling. Faculty need to examine barriers to teaching these skills because the curriculum should address all legal pregnancy options, including discussing the NP's professional obligations. More preparation was needed in the clinical management of erectile dysfunction, polycystic ovary syndrome, herpes, syphilis, abnormal uterine bleeding, dyspareunia, pelvic pain, miscarriage management, and how to discuss prostate cancer screening. IMPLICATIONS FOR PRACTICE: The recommendations of the quality family planning, with additions, form a sound basis for sexual and reproductive health care standards, education, and clinical practice, should be part of NP education.

Longitudinal study of advanced practice nurses' implementation of screening intervals for cervical cancer screening.

BACKGROUND AND PURPOSE: The past two decades brought changes in cervical cancer screening guidelines. Frequent modifications and earlier lack of agreement about recommendations created confusion. The purpose of this study was to explore to what extent advanced practice nurses (APNs) adopted cervical cancer screening guidelines. METHODS: A longitudinal survey of 358 APNs conducted in three New England states regarding cervical cancer screening practices in 2008, 2012, and 2015. CONCLUSIONS: Advanced practice nurses are incorporating guidelines at a high rate. Advanced practice nurses found it easier to incorporate guidelines to delay screening until the age of 21 years, to discontinue screening after total hysterectomy for benign reasons, and to discontinue screening at the age of 65 years. In 2012, 15% of APNs were screening women aged 21-29 years every 3 years; by 2015, this rate rose to 72%. By 2015, half of APNs were screening low-risk women aged 30-64 every 5 years. Because screening practices changed, APNs questioned the need to perform screening pelvic and breast examinations. Advanced practice nurses no longer perform screening pelvic examinations (93%) or breast examinations (75%) in adolescents. IMPLICATIONS FOR PRACTICE: Some APNs indicated that office-based practice standards are barriers to adherence to guidelines. Advanced practice nurses need to be involved in practice committees to ensure that evidence guides practice decisions.

The SEARCH Project: Acquainting Students in the Health Professions with Interprofessional Care.

The SEARCH NH project (Student Experiences and Rotations in Community Health in New Hampshire) was a 3-year collaboration of the New Hampshire Area Health Education Center, four educational institutions, and four community health centers. The purpose was to introduce students in the health professions to interprofessional care in underserved areas. It was funded by the National Health Services Corps. The background of the project, its development, and findings are described. Seventy-four students from undergraduate and graduate nursing programs, a physician assistant program, and a medical school participated. Prior to a focused immersion experience in a community health center, they were exposed didactically to concepts of interprofessional care. Findings from the collaborative project are reported using a clinical microsystems framework to analyze student reflections on their experiences and resultant learning. In quotes offered as exemplars, students report increased appreciation of the clinical microsystem's 5 Ps: purpose, professionals, patients, patterns, and processes in interprofessional work.

Clinical issues in post-abortion care.

This article provides an overview of the clinical issues in post-abortion care, including types of abortion procedures, expected post-abortion course, possible complications, and the components of the post-abortion visit. By providing follow-up care to their patients, NPs can increase continuity of care and promote successful contraceptive use.

Bring the popcorn: using film to teach sexual and reproductive health.

The use of film as a teaching modality offers an opportunity for nursing students to explore the intersections of science, theory, and personal values prior to caring for clients with sexual and reproductive health (SRH) needs. Although the use of a broad range of arts and humanities modalities in the classroom is described in the literature, the use of film in relationship to teaching SRH has not been explored. Furthermore, there is a paucity of literature regarding the didactic or clinical teaching of SRH in nursing education. This article provides a framework for incorporating film as a teaching strategy into both case-based and problem-based teaching pedagogies. Reviews and discussion questions of films are provided.