DNP Scholarly Projects


Integrating Contraception Counseling in a Residential Substance Use Disorder Treatment Setting: A Quality Improvement Project


Despite recommendations from professional organizations and the expressed preferences of women in treatment, few substance use disorder treatment facilities provide contraception counseling and services. This phased quality improvement project based on Donabedian’s Structure Process Outcome model was designed in response to the expressed preferences of women in treatment as well as the translation of best practice recommendations to integrate contraception counseling services in two substance use disorder treatment facilities in middle Tennessee. Structural analyses at both sites identified behavioral and medical staff to complete an online contraception counseling training module, modifications to the intake process and electronic health record, and appropriate follow-up for patients desiring contraception counseling. Outcomes of the processes implemented include the integration of group and individual contraception counseling at both sites. Between both sites a total of eight staff members completed the training. 22 women admitted during the project’s timeframe participated in group contraception counseling at one site. Despite this, none of the women wished to initiate contraception during their treatment stay. At the other implementation site, 13 women completed individual contraception counseling with all women desiring either a Tier 1 or Tier 2 contraception method following counseling. Additionally, protocols were developed at both sites allowing for the access and initiation of one’s desired contraception method during a patient’s treatment stay. Such outcomes highlight that some women in treatment desire contraception counseling and services while in treatment. Thus, structural analyses and process interventions that integrate contraceptive care into the addiction treatment milieu may improve access.


Spring 4-9-2021

First Advisor

Elizabeth Morse

Scholarly Project Team Member

David Phillippi

Scholarly Project Team Member

Tracy Frame


Nursing, School of


Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project


Doctorate of Nursing Practice (DNP)

Degree Level


Degree Grantor

Belmont University


contraception; contraception counseling; substance use disorder; staff training; quality improvement; service integration

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