Jasmina Kostoski
Speeches:
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Nurse’s role in medical abortion up to nine weeks of pregnancy in a day hospital unit
Jasmina Kostoski, Sanja Perić, Vlasta Slapničar University Medical Centre Ljubljana, Ljubljana, Slovenia - jasmina.kostoski@gmail.com
Introduction: The Day Hospital is part of a Reproductive Unit which contains an operating room for aseptic interventions and three hospital rooms with 14 bed units. This is the main unit for all kind of abortions and minor operative procedures in gynaecology. The average annual number of patients is between 2500 and 2700. 1,232 abortions up to 10 weeks are performed, of which 766 medical abortions were recorded last year. Organization and workflow: Patients are coming to the Day Hospital with an already signed application for termination of pregnancy up to 10 weeks of gestation. A nurse will interview the patient in order to determine which kind of abortion will be the most appropriate (depending on the level of pregnancy, her expectations and any additional diagnosis). If medical abortion is appropriate, the patient is going back to the nurse who will give her a prescribed tablet of mifepristone. Together, they will make a plan for the further course of pregnancy termination considering the patient’s career and family responsibilities. The patient will not leave the hospital without having received all the needed spoken and written instructions from the nurse. Approximately 36-48 hours after taking the tablet, the patient is returning. After a brief interview in relation with the course of the first part of the medical abortion, the nurse will give the patient a tablet of NSAID and place the patient into the bed unit. After that the nurse or the resident will insert 4 tablets of misoprostol in her vagina. During that time, nurses are taking good care of the patient, helping to alleviate the possible pain and sickness by giving medications and controlling bleeding and pain. After 3 to 4 hours, the nurse is giving further instructions to the patient who will be able to safely leave the hospital.