Evidence map›Paper›PMID 36701296›Full record

ArticlePloS one2023

Barriers and enablers to nurse practitioner implementation of medication abortion in Canada: A qualitative study.

Andrea Carson, Emma Stirling-Cameron, Martha Paynter, Sarah Munro, Wendy V Norman, Kelley Kilpatrick, Stephanie Begun, Ruth Martin-Misener

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Andrea CarsonSchool of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.ORCID 0000-0003-4223-9418
Emma Stirling-CameronFaculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
Martha PaynterSchool of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.
Sarah MunroDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
Wendy V NormanDepartment of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.ORCID 0000-0003-4340-7882
Kelley KilpatrickIngram School of Nursing, McGill University, Montreal, Quebec, Canada.
Stephanie BegunFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
Ruth Martin-MisenerSchool of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.
Dalhousie University · CAUniversity of British Columbia · CAMcGill University · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In this study we explored nurse practitioner-provided medication abortion in Canada and identified barriers and enablers to uptake and implementation. Between 2020-2021, we conducted 43 semi-structured interviews with 20 healthcare stakeholders and 23 nurse practitioners who both provided and did not provide medication abortion. Data were analyzed using interpretive description. We identified five overarching themes: 1) Access and use of ultrasound for gestational dating; 2) Advertising and anonymity of services; 3) Abortion as specialized or primary care; 4) Location and proximity to services; and 5) Education, mentorship, and peer support. Under certain conditions, ultrasound is not required for medication abortion, supporting nurse practitioner provision in the absence of access to this technology. Nurse practitioners felt a conflict between wanting to advertise their abortion services while also protecting their anonymity and that of their patients. Some nurse practitioners perceived medication abortion to be a low-resource, easy-to-provide service, while some not providing medication abortion continued to refer patients to specialized clinics. Some participants in rural areas felt unable to provide this service because they were too far from emergency services in the event of complications. Most nurse practitioners did not have any training in abortion care during their education and desired the support of a mentor experienced in abortion provision. Addressing factors that influence nurse practitioner provision of medication abortion will help to broaden access. Nurse practitioners are well-suited to provide medication abortion care but face multiple ongoing barriers to provision. We recommend the integration of medication abortion training into nurse practitioner education. Further, widespread communication from nursing organizations could inform nurse practitioners that medication abortion is within their scope of practice and facilitate public outreach campaigns to inform the public that this service exists and can be provided by nurse practitioners.

Indexed as

Abortion, InducedAbortion, SpontaneousNurse PractitionersCanadaDelivery of Health CareFemaleHumansPregnancy

Identifiers

PMID36701296
PMCPMC9879445
OpenAlexW4318149661

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.