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RCOG World Congress 2025
June 23 - 25, 2025 | ExCeL London, UK
EP.1901
Evaluating Compliance with National Guidelines for IUD Insertion: A Retrospective Audit
Poster Presenter
Part of Topic
Quality improvement
Intrauterine device insertion in outpatient hysteroscopy:
a cross-site audit into clinician compliance with local and national guidelines
BACKGROUND
•The insertion of intrauterine devices (IUDs), particularly the Mirena®, is commonly performed in outpatient hysteroscopy (OPH) settings for a range of gynaecological indications including abnormal uterine bleeding, hormonal replacement therapy, and contraception.
•To ensure patient safety and procedural success, national guidelines from the Royal College of Obstetrics and Gynaecologists (RCOG), Faculty of Sexual and Reproductive Healthcare (FSRH), and the British Menopause Society (BMS) provide standards for clinical assessment, documentation and post-insertion care for this procedure.
OBJECTIVES
•The aim of this audit was to evaluate clinician compliance with national and local guidelines in the insertion of IUDs at Chelsea and Westminster Hospital (CWH) and West Middlesex Hospital (WMH) in London, UK.
METHODS
•A retrospective audit conducted, involving 122 electronic patient records (Cerner) for all patients who underwent Mirena IUD insertion in OPH setting at CWH (April – October 2024) and WMH (April – November 2024).
•Key metrics included indication for insertion, clinical assessments (e.g. urine pregnancy test, last menstrual period, parity), consent and chaperone documentation, IUD characteristics (type, strength, off-licence use), procedural details (e.g. uterine cavity and thread length), clinical grade, and post-procedure care (e.g. coil card, follow-up plan, patient information)
CONCLUSIONS
•IUD type was documented in majority of patient records, however, the IUD strength was not specified as often.
•Overall, post-procedure information is well-documented, including informational leaflets, advice, and a follow-up plan.
•Details relating to the procedure was not well documented, as uterine cavity length was only documented 37% of the time and thread length 2% of the time.