Uterine evacuation with manual vacuum aspiration ... - CommonHealth

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❑ If the learners will be divided into groups or will practice at different sites, arrange for additional trainers, because each learner must be directly supervised by a trainer. ❑ Employ principles of adult learning and maintain a positive learning environment. Before the Practicum ❑ Identify when caseload at the practicum site is highest. To build caseload, consider asking local facilities to refer women coming for abortion services to the practicum site during the training period. Alternatively, schedule women for endometrial biopsy during the practicum and allow learners to perform the procedure, as the skill is similar to uterine evacuation. ❑ Ensure that practicum-site protocols, equipment and supplies are consistent with skills to be taught; decide how to handle any noted discrepancies. • If necessary, adapt training activities to more closely reflect practicum-site practices, or create additional activities. ❑ Determine where review and debrief discussions can take place before and after practice. This may be a private room on- or off-site. ❑ Determine how to keep track of learners who have successfully achieved competency and those who need more practice, as well as how the latter will receive that additional practice. During the Practicum ❑ Refer to the Reference Manual frequently during review, debriefing and other discussions with learners. ❑ Assign learners to practice procedures according to their skill level. ❑ Assign a few learners and a trainer to work together in ―practice groups.‖ Pair strong learners with weaker ones and ask them to help each other. Once some learners have reached competency, they can help those who have not. Ensure learners understand what their roles are, what the other learners’ roles are and how to assist other learners. ❑ Limit the number of learners and observers for each procedure. ❑ Obtain the client’s permission for learners to perform the procedure, ensuring she understands that the trainer will be present and that she has the right to refuse without being denied care. ❑ Always respect the woman’s right to confidentiality and privacy, not only in direct care but also when discussing her care with learners. ❑ Only give corrective feedback to learners in the presence of a client when the mistake could endanger her or cause her discomfort, in order to limit the anxiety of the client as well as the learner. ❑ Carefully monitor the practicum to ensure that other trainers are following agreed-upon protocols and using the checklists; to problem-solve issues that arise; to ensure that practice groups are working well; and to make certain that every learner is getting opportunities to participate. ❑ In addition to leading a debrief discussion, consider seeking feedback from learners after each session. ❑ Use the Clinical Skills Evaluation form in this module for evaluating learners to determine if they can be considered competent in abortion-care skills. After the Practicum ❑ Provide the evaluation for learners to complete ❑ Debrief with site staff and other trainers about what worked well and how the clinical practicum could be improved, and thank everyone for their participation. ❑ Provide each learner with specific recommendations for implementing and improving their skills when they return to their sites. ❑ Provide feedback on each learner’s skills to their site supervisor, if appropriate. ❑ Provide opportunities for refresher courses and site-visit exchanges between learners. ❑ Ask the learners what they see as their most important next steps and how you might assist them. UTERINE EVACUATION WITH MVA: A TRAINING MANUAL FOR CONDUCTING SHORT COURSES Page 32
Tool C-6: MVA Procedure Checklist: Incomplete/Missed Abortion INSTRUCTIONS: Provide a copy to each participant for use during training on pelvic models. Only one version of this tool is printed below, but the CD-ROM contains both versions. MVA Procedure Checklist: Incomplete/Missed Abortion Skills Yes No Comments Creates pain management plan Tailors pain management plan with woman according to her needs Discusses sources of pain, options, potential side effects Includes combination of support and pharmacological measures Takes into account woman’s medical and psychological status, dilatation necessary, staff skill, nature of procedure and availability of supplies Prepares the instruments Checks vacuum retention of aspirator Has more than one instrument available Prepares the woman Administers pain medication in timely fashion Asks woman to empty her bladder Asks what supportive measures she would like and provides them Asks for permission to start Puts on barriers and washes hands Performs pelvic exam to confirm assessment findings Warms and inserts speculum gently Removes foreign bodies in os; refers if bowel present Performs cervical antiseptic prep Follows No-Touch Technique Uses antiseptic sponges to clean os and, if desired, vagina Administers paracervical block Uses less than 200mg lidocaine Aspirates before injecting 1–2mL at tenaculum site Places tenaculum Applies slight traction to expose tissue transition Slowly injects 2–5mL lidocaine to 1–1.5 inches at 3,5,7 and 9 o’clock Dilates cervix if needed Inserts cannula Applies gentle traction to cervix Rotates cannula while gently applying pressure Inserts cannula to just past internal os OR to fundus and pulls back Suctions uterine contents UTERINE EVACUATION WITH MVA: A TRAINING MANUAL FOR CONDUCTING SHORT COURSES Page 33
Page 1 and 2: Uterine Evacuation with Manual Vacu
Page 3 and 4: Manual Vacuum Aspiration (MVA) Each
Page 5 and 6: The Courses The three courses vary
Page 7 and 8: Ipas policy/guidelines on clinical
Page 9 and 10: the trainer/presenter not wish to i
Page 11 and 12: MVA Course 301: Supervised Clinical
Page 13: Tools
Page 16 and 17: Tool A-1: MVA 101 Course Overview (
Page 18 and 19: Tool A-3: MVA 101 Recommended Mater
Page 20 and 21: Tool A-5: MVA 101 Course Evaluation
Page 22 and 23: Tool A-6: MVA 101 Certificate Templ
Page 24 and 25: B) MVA Course 201 The materials pri
Page 26 and 27: Tool B-3: MVA 201 Sample Materials
Page 28 and 29: Tool B-4 MVA 201 Sample Planning Ch
Page 30 and 31: Tool B-6: MVA Procedure Checklist:
Page 32 and 33: Tool B-7: MVA 201 Sample Learning A
Page 34 and 35: 13. Paracervical block by itself is
Page 36 and 37: 4. Now that I have completed this c
Page 38 and 39: Tool B-10: Information on Instrumen
Page 40 and 41: Tool C-2: MVA 301 Sample Agenda for
Page 42 and 43: 1 per participant plus extras Proce
Page 44 and 45: 5 weeks prior Advertise, invite par
Page 48 and 49: Holds tenaculum and end of cannula
Page 50 and 51: Clinical Skills Evaluation UTERINE
Page 52 and 53: Sample Learning Assessment Tool for
Page 54 and 55: Tool C-8: MVA 301 Course Evaluation
Page 56 and 57: Tool C-9: MVA 301 Certificate Templ
Page 60: E-09-MVA-008 Rev. 0 12/2009 MVASRTC

Uterine evacuation with manual vacuum aspiration ... - CommonHealth

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