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Check list for IUCD Insertion

This document is a checklist for the clinical skills required for the insertion of the IUCD (Cu-T 380A). It outlines the steps and tasks to be performed, along with a scoring system to evaluate competency in each task. The checklist includes client interaction, procedural steps, and post-insertion instructions.

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Mila Reta
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12 views

Check list for IUCD Insertion

This document is a checklist for the clinical skills required for the insertion of the IUCD (Cu-T 380A). It outlines the steps and tasks to be performed, along with a scoring system to evaluate competency in each task. The checklist includes client interaction, procedural steps, and post-insertion instructions.

Uploaded by

Mila Reta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CHECK LIST FOR IUCD (Cu-T 380A) INSERTION CLINICAL SKILLS

2 - Competently performed: Step or task performed correctly and in proper sequence

1 - Needs Improvement: Step or task performed correctly but out of sequence

0 - Not done or done incorrectly: Step or task omitted or not performed correctly

Name _____________________ Course- Family Planning Date: _____________________

STEP/TASK
0 1 2 Remark
1. Greet client politely, introduce one self, offer a seat and
ensure privacy for IUCD insertion.
2. Ask client if she still wants the IUCD (CU-T 380A) inserted.

3. Review with client information in her record and ensure that she
has been appropriately counseled for IUCD (CU-T 380A)
insertion; ask client what questions she has about the IUCD (CU-T
380A) or the insertion
4. Review reproductive goal and pertinent general medical history
with client. To confirm that the IUCD (CU-T 380A) is an
appropriate choice for the client:
 Review Client Screening Checklist to ensure that the
client is not pregnant:

STEP/TASK
0 1 2 Remark

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5. Provide more detailed information about IUCD (Cu-T 380A)
 Show the client the package of IUCD (Cu-T 380A)
 How it works,
 Its effectiveness,
 Its characteristics,
 How it is inserted and what to expect,
 Common side effects,
 When to return.
 Inform the client that it will need to be removed at the
end of 12 years or anytime she decides to stop using the
IUCD.
6. Ask the client to repeat information to ensure that she
understands
7. Ensure that needed supplies and equipment are available in
the procedure room
8. Help the client onto the examination table

9. Explaining to client what you are doing at each step; ask her to tell
you if she experiences discomfort; remind her to take deep breaths
and relaxspeculum exam by gently spreading the labia with two
10. Perform
fingers and then inserting a bivalve speculum, starting obliquely
Gently open and maneuver the speculum to be able to inspect the
cervix and check for vaginal lesions or discharge
Place, screw and lock the speculum and then rotating it clockwise to
the horizontal position:

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Load the Copper T 380A
 while it remains inside the sterile package:
11. Partially open package (up to one third) and bend back the
package flaps
12. Put the white rod inside the inserter tube
13. Place the package on a flat surface
14. Slide the white measurement card (that is in the package)
15. underneath the arms of the IUCD (CU-T 380A)
16. Hold the tips of the IUCD (CU-T 380A) arms and push on
the inserter tube to assist in bending the arms
17. When the arms touch the sides of the inserter tube, pull the
inserter tube away from the folded arms of the IUCD (CU-T
380A)
18. Elevate the inserter tube and push and rotate it to catch the
tips of the arms in the tube

19. With the loaded IUCD (CU-T 380A) still in the partially
opened sterile package, move the flange (blue depth gauge)
to the corresponding measurement obtained from sounding
the uterus

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STEP/TASK
0 1 2 Remark
20. Press down on the flange with one finger to keep it stable, and
with the other hand slide the loaded inserter so that the tip of
the IUCD (CU-T 380A) aligns with the tip in the diagram on
the white measurement card.
 Make sure the white rod is against the tip of the vertical
arm of the IUCD (CU-T 380A).

21. Complete opening the plastic cover of the package in one


continuous movement with one hand, while holding the tube
and rod down against the table (at the open end of the
package) with the other hand.
22. Remove the loaded inserter tube without touching anything
that is not sterile.
23. pass the loaded inserter tube through the
cervix until the flange touches the cervix or slight resistance is felt
(without touching the vagina and blades of the speculum)

24. Release the arms of the IUCD (CU-T 380A) using withdrawal
technique: Pull the inserter tube toward you while holding the
white rod stable. This will release the IUCD (CU-T 380A)
25. Remove
arms. the white rod

26. Carefully move the inserter tube upward toward the top of the
uterus until slight resistance is felt. (This helps ensure that the
IUCD (CU-T 380A) is inserted high in the fundus)

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STEP/TASK 0 1 2 Remark
27. Partially remove the inserter tube from the cervical canal until
IUCD strings can be seen protruding from cervical os.
28. With the strings stabilized inside by the partially removed
inserter tube cut the IUCD (CU-T 380A) strings to 3 cm length
and remove the inserter.
29. Gently remove the speculum, pull it out while gently closing
the blades and rotating it counterclockwise to the vertical
position and place it in 0.5% chlorine decontamination
solution
30. Dispose of waste materials

31. Remove gloves by turning them inside out.

32. Wash hands thoroughly with soap and water and dry with
clean, dry cloth or air dry.

Provide post insertion instructions:


33. Inform the client how many years the IUCD (CU-T 380A) is
effective (give in writing), and that the IUCD (CU-T 380A) is
effective immediately with no need for backup contraception
34.Explain that some women like to check the IUCD (CU-T
380A) strings after their period to assure themselves that the
IUCD (CU-T 380A) is in place

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STEP/TASK
0 1 2 Remark
35.Explain when to return, have client repeat instructions and
correct/clarify as needed:
36.Follow-up visit (after her first period or within 3 to 6 week
whichever comes first); give appointment if possible
37.Any time she has any concerns or problems
38.If she experiences warning signs such as late or unusually
heavy period, abdominal pain, signs of infection such as fever,
tenderness and abnormal discharge
39.Remind client of condom use for STI protection
40.Explain that the IUCD (CU-T 380A) can be removed whenever
client wants, but that it needs to be done by a provider; the
client must not attempt to remove the IUCD herself

41. Complete the IUCD card, client record and IUCD register Or
document

Total score______/82 % ________/15%

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