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Methods of Documentation III: PIE01:21

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Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
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Optimal Pessary Care: A Modified Delphi Consensus Study.

Gwendolyn L Hooper, Shanna Atnip, Katharine O'Dell

    Journal of Midwifery & Women'S Health
    |July 21, 2017
    PubMed
    Summary
    This summary is machine-generated.

    Expert nurse providers reached consensus on 22 key areas of pessary care for women with vaginal prolapse, guiding clinical practice and education where evidence is limited.

    Keywords:
    Delphi techniqueconsensusprolapse treatmentprovider educationvaginal pessary

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    Area of Science:

    • Urogynecology
    • Pelvic Floor Disorders
    • Medical Device Management

    Background:

    • Support pessaries are a low-risk treatment for vaginal prolapse, yet optimal practice guidelines are lacking.
    • While physicians commonly prescribe pessaries, the role of non-physician providers in pessary care is not well-defined.
    • This study aimed to gather expert opinions from nurse providers on pessary management to inform clinical practice.

    Purpose of the Study:

    • To achieve consensus among expert nurse providers on key aspects of vaginal support pessary care.
    • To develop evidence-based recommendations for patient and provider education, documentation, and management.
    • To identify areas requiring further research in pessary care.

    Main Methods:

    • A 4-round modified Delphi technique was employed, involving online surveys and face-to-face meetings.
    • Nurse providers rated statements on a 3-point scale (agree, disagree, neutral) and provided comments.
    • The study aimed for at least 80% agreement among at least 6 expert nurse pessary providers.

    Main Results:

    • Consensus (over 80% agreement) was achieved on 22 statements covering patient/provider education, terminology, pessary management, and follow-up.
    • Key areas of agreement include patient education, provider training, and routine follow-up protocols.
    • No consensus was reached on the use of vaginal estrogen, antimicrobials, or managing mechanical injury.

    Conclusions:

    • Expert nurse providers established consensus recommendations to enhance clinical care and education for vaginal support pessaries.
    • Areas lacking consensus highlight critical gaps for future research in pessary management and cost-effective care.
    • The findings provide a foundation for developing standardized educational materials for new pessary providers.