Scribd
Upload
36 views2 pages

MSI CA Checklist - Emergency Contraception v1.0

This document outlines the steps a clinical staff member must demonstrate competency in to provide emergency contraception (EC) services. It includes 10 steps such as taking a medical history, obtaining informed consent, identifying the appropriate EC option, ensuring eligibility, administering EC, and documenting the interaction. The staff member is assessed as either Level 1, where all steps are completed correctly and they can provide EC independently, or Level 2, where they missed steps and need direct supervision before being endorsed as fully competent.

Uploaded by

Abubakar Jalloh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
36 views2 pages

MSI CA Checklist - Emergency Contraception v1.0

This document outlines the steps a clinical staff member must demonstrate competency in to provide emergency contraception (EC) services. It includes 10 steps such as taking a medical history, obtaining informed consent, identifying the appropriate EC option, ensuring eligibility, administering EC, and documenting the interaction. The staff member is assessed as either Level 1, where all steps are completed correctly and they can provide EC independently, or Level 2, where they missed steps and need direct supervision before being endorsed as fully competent.

Uploaded by

Abubakar Jalloh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

MSI Competency Assessment Checklist: Emergency Contraception

Clinical Staff Name: _______________________ Designation: _______________________

Emergency Contraception (EC) Yes/No/ Notes


NA

1. Takes a relevant history from the client as per the MSI Guidelines for Emergency
Contraception

2. Ensures informed consent by confirming that the client understands all key
points, for example:
• Effectiveness of all available emergency contraception (EC) options,
including the copper intrauterine device (CuIUD) as the most effective
option
• The sooner EC is taken, the more effective it is
• EC does not disrupt an existing pregnancy
• Emergency contraceptive pills (ECPs) will not protect from pregnancy from
any episodes of unprotected sex that occur after they take the ECPs
• If they are taking certain medications the effectiveness of ECPs maybe
reduced

3. Correctly identifies the appropriate EC option for the client based on available
EC options, eligibility, and client choice

4. Ensures that the client is eligible for ECP by confirming that the client had
unprotected sexual intercourse (UPSI) in the last 5 days (NA for CuIUD)

5. Determines whether a client can have a CuIUD as EC, by confirming that (NA
for ECPs):
• The client is not currently confirmed to be pregnant
• All unprotected sex since the start of their last natural menstrual period has
taken place in the last 5 days
• When the earliest likely day of ovulation can be estimated, the client can
have an IUD inserted up to 5 days after ovulation (this step is not required
to be a level 1 provider)

6. Confirms client is medically eligible for a CuIUD (NA for ECPs)

7. Counsels client for regular contraception by assessing client needs and


providing information on contraceptive methods that fit with the client’s eligibility
and lifestyle preferences

8. Gives accurate instructions on when the client can start or restart regular
contraception after taking ECPs, and if use of back up protection is needed (NA
for CuIUD)

9. Administers EC and advises client:


• About instructions for self-administration of chosen ECPs, if required (NA
for CuIUD)
• That they must return if they think they might be pregnant e.g. they have
symptoms of pregnancy, or their period is 1-2 weeks late
• That they should do a pregnancy test at least 21 days after their last episode
of UPSI

10. Completes documentation in client records including:


• Type of ECP/CuIUD used, batch number, expiry date

MSI Competency Assessment Checklist – Emergency Contraception v1.0 Page 1 of 2


Result of Competency Assessment
* Attach Competency Assessment Checklist if clinical staff is assessed as Level 2

Tick as
Service Assessed: Emergency Contraception
appropriate

Level 1
• Individual completed all steps correctly.
• Competent to provide this service independently subject to regular re-assessment.

Level 2
• Individual missed one or more of the steps.
• Cannot provide this service independently. Must offer this service only under direct
supervision of a competent clinical staff till endorsed as fully competent by the competent
clinical staff.

Other observations:

Specify action(s) to be taken to achieve/maintain competency:

Clinical Staff Name: Clinical Staff Signature:

Competency Assessor Name: Competency Assessor Signature:

Date of Assessment: Location:

MSI Competency Assessment Checklist – Emergency Contraception v1.0 Page 2 of 2

You might also like