Pessary Practices of Nurse-Providers in the United States

Abstract

OBJECTIVES: Our purposes were to describe pessary-care practices and education of a sample of nurse providers in the United States and identify a cohort of high-volume providers. METHODS: An e-mail survey was sent to members of 3 related nursing professional organizations. Questions addressed general pessary care within the respondent's practice and specific pessary care choices of responding direct providers. Data were managed using REDCap electronic data capture tools. RESULTS: Of 323 respondents, 279 (86.4%) reported pessary care occurred in their office settings, 84.5% of which were urban or suburban, and 65.4% were private practices. Responders were evenly distributed through 4 regions of the United States and represented a variety of specialties. Physicians and advanced practice registered nurses provided the majority of care (up to 80%), along with registered and licensed practical nurses and medical assistants. Care routines varied, most often including 3-month-interval follow-up with speculum-assisted vaginal examinations and no routine use of vaginal products (eg, moisturizers, acidifiers, antimicrobials, or vaginal estrogens). On-the-job mentoring was the primary knowledge source (64%). Comparison of practice patterns suggested possible variation by region and certification. CONCLUSIONS: This exploratory study provides data related to the pessary-care practices of nurse providers in the United States. The range of responses emphasizes a need for evidence-based guidelines for optimal care, based on patient outcomes, satisfaction, and costs of care. Findings also illustrate a need for effective, evidence-based educational programs and clinical mentorship options with experienced providers. A cohort of expert providers was identified to continue work toward these goals.