Uterine evacuation with manual vacuum aspiration ... - CommonHealth

Clinical Skills Evaluation
UTERINE EVACUATION FOR INCOMPLETE/MISSED ABORTION:
Instructions: The trainer should use one form to evaluate the ability of each learner based on direct observation of
the learner’s management of an incomplete abortion case, including performance of manual vacuum aspiration
(MVA). Proficiency in MVA service delivery requires demonstrating competency on all items in Part I. If a learner
does not demonstrate competency or cannot be observed, refer to Part II where recommendations can be made as to
how performance might be improved to achieve competency. After completing the form, the trainer should discuss
the results with the learner.
Mark an X in the box next to each step that is competently demonstrated by the learner.
I. Clinical Skills
❑ 1. Establishes rapport with the woman, helping her feel comfortable
❑ 2. Assesses the woman’s status: medical history, presenting conditions, date of LMP, emotional state
❑ 3. Provides or confirms that the woman received counseling: privately explores her decisions
❑ 4. Discusses the procedure with the woman and obtains consent
❑ 5. Evaluates need for and administers pain management based on the woman’s condition and her desires
❑ 6. Uses infection-prevention practices: handwashing, gloves
❑ 7. Assesses uterus: size, position, trauma
❑ 8. Identifies cervical laceration or trauma
❑ 9. Identifies possible reproductive tract infection
❑ 10. Ensures that the cannulae are HLD or sterile and rinsed of caustic solutions
❑ 11. Prepares aspirator and checks vacuum
❑ 12. Selects cannula based on uterine size and dilatation; inspects cannula and aspirator for wear
❑ 13. Swabs cervix, and vagina if desired, with antiseptic solution
❑ 14. Administers paracervical block and any other medications; allows time for medications to take effect
❑ 15. Dilates the cervix, if needed
❑ 16. Inserts cannula and attaches aspirator
❑ 17. Uses no-touch technique; does not contaminate the cannula
❑ 18. Moves cannula effectively to empty the uterus
❑ 19. Stops evacuation when signs of completion are present
❑ 20. Examines the aspirate to assure it is consistent with the woman’s condition
❑ 21. Assures post-procedure care is provided to monitor and discuss her recovery
❑ 22. Assures contraceptive counseling and a method are provided if the woman desires
❑ 23. Assures follow-up care is scheduled with referrals made where needed
II. Recommendations.
For skills that were not performed to competency or were not observed, suggest recommendations to be followed,
for example: “needs to continue practice under supervision” or “repeat clinical training.”
Item
Recommendation
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UTERINE EVACUATION WITH MVA: A TRAINING MANUAL FOR CONDUCTING SHORT COURSES Page 36