Managing a Pessary Business - SUNA

Figure 1.Sample Decision Tree for Pessary Practice ManagementWill practice provide pessary care?NoKnow referral optionsYesFitting and follow upFitting kitsonlyPurchase at leastone kit from eachcategory. Checklocal pharmacies/medical equip -ment storesrelated to optionsfor patientpurchase.Will care include fitting or only follow up?Completearray ofpessariestypes andsizesPurchase stock; planstorage, inventory,ordering methodsLimited pessarystockFollow up onlySelect and purchasecommon sizes of atleast one type ofpessary from eachcategory. Knowreferral options.No special equipment ifsite provides women’shealth services; knowreferral options.SPECIAL SERIES ON PESSARIESComplete equipment checklist (see Table 1)tained by relatively intact pelvicmuscle integrity, support pessariesthat are somewhat selfretaining,and pessaries that offeradditional urethral support forwomen with stress urinary in -continence. Some large referralpractices may have sufficientvolume of potential pessary usersto justify stocking several stylesof each category of pessary, aswell as a complete range of sizesof each style. Smaller practiceshave several options for limitingtheir up-front purchasing costs.Table 1.Office Resources Necessary for Pessary ManagementAssorted pessaries and/or fitting ringsPessary cleaning plan prior to re-sterilizationAutoclave, cold, or alternate sterilizationAppropriate educational materialsFollow-up visit tracking systemAfter-hours contact and referral planGeneral pelvic examination equipment, including options for vaginitis and urinarytract infection screeningPessary cart or other storage areaInventory and re-order planUROLOGIC NURSING / May-June 2012 / Volume 32 Number 3 139