Discuss a new skill that you have learned within the clinical setting. Support how you will implement this new skill into your practice using recent evidence and relevant guidelines.

answer:

this week clinical , I observed and learned about Pessary insertion. A pessary is a device to prevent pelvic organ prolapse which increases urinary incontinence. doctor will decide which type of pessary you should use depending on the problem you have. The pessary has to be fit just right in order to work correctly and be comfortable This insertion is performed in the office by an Nurse Practitioner with the use lubricant to make placement easier. in some cases the surgical approach is one of the conventional treatment for patients, the use of the pessary is a conservative method for patients who would like to avoid surgery.Additionally, advantage :

Pessary is considered as a first-line because of its low-cost, low-risk and noninvasive treatment.

The specific patient I observed was a 79 year female with a history of a Total Abdominal Hysterectomy over twenty years ago. she came to visit as she had a pessary inserted last week that came out after two days. The procedure took about 20 minutes, and the patient tolerated it well without any discomfort. After insertion of pessary , we advised the patient to walk around. The NP wanted to ensure that the device was the appropriate size and monitor for any discomfort patient might have during ambulation. As an observer, I thought it would be excruciating, but the patient didn’t complain of any discomfort. There are several types and options for different sizes and shapes.

Reference

Coelho SCA, Giraldo PC, Florentino JO, et al. Can the Pessary Use Modify the Vaginal Microbiological Flora? A Cross-sectional Study. Rev Bras Ginecol Obstet 2017; 39:169.

my professor asked me

Still need “Support how you (as NP) will implement this new skill into your practice using recent evidence and relevant guidelines.”