Transcript Nurses and LARC - London Sexual Health Programme

The London Sexual Health Programme
LARC for London Conference
Nurses and LARC
Kathy French RN, BSC (Hons)
PhD, MPhil
2nd Dec 2011
The London Sexual Health Programme
Aim of this session
• Look back in time?
• Training Programmes/accreditation/reaccreditation
• Use of Patient Group Direction (PGDs)
• The role of Higher Educational Institutes
(HEIs) in preparing nurses for this role?
• Highlight what nurses are doing in London
in terms of LARC
• Links with practice nurses
History of nurses and LARC
• In some parts of the world, nurses,
midwives and physician assistants fit IUDs
and SDIs as part of their role.
• Sweden, some states in America, South
Africa, Vietnam and others
• In the late 1970s at Kings College Hospital
London, six nurses in contraception were
trained to fit IUDs
Nurses and LARC
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• The clinics would fit as many as ten+ IUDs
in one session
• The nurses were trained and supervised
by the doctors and each nurse was
assigned to a doctor until she was deemed
competent
• Little was written about this work apart
from a small piece in a midwives
magazine -The Chronicle of Midwives
1979
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• In 2001/02 guidelines were drafted with
others for nurses in the insertion of SDIs
and IUDs
• These guidelines were based on the
FSRH guidelines for doctors
• In 2005 we held two theory days at the
RCN on IUDs and SDIs – both were over
subscribed
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• The Margaret Pyke took this on and
offered theory days in London and
Birmingham
• This lead to many nurses in the four
countries seeking accreditation at the RCN
• More nurses are inserting SDIs
• Re accreditation is every five years with a
stated number of IUD/SDI to be fitted each
year to maintain competencies
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• Nurses must hold a recognised course in
contraception/sexual health
• See enough women seeking contraception
to ensure they get enough wanting LARC
• Have the support of their manager to do
this work
• Audit their work
• Ensure they have PGDs in place for the
SDI, IUS and Lidocaine
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• Issues and barriers to training?
• Some nurses get trained without meeting
the criteria
• It is not the responsibility of the trainer to
ensure they have met the RCN criteria
• Vicarious liability rests with the employer
• Need to be a member of a professional
body and union
• Cost of training and accreditation
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• Many nurses in SHS in London are fitting
SDI’s and IUD/IUS’s
• Audit showed that over 126 nurses were
fitting SDIs and 37 fitting IUDs (Nov 2011)
• Lewisham and Camden over 20 in each
service but some services none.
• It may not be necessary for nurses to be
trained in LARC?
• No feel for what practice nurses are doing
in London?
Nurses and LARC
• Few nurses are training others at the
moment (external nurses)
• Many London nurses are not seeking RCN
accreditation because of the increased
fees (£300 for members and £400 for NM
• Pan London ‘standard’ drafted and on the
LSHP website linked to the RCN/FSRH
gold standard
• Pelvic bi -manual training needed for
IUD/IUS
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• Encourage nurses who are training to
write about their work
• More coordination is needed in London to
link practice nurses with SRH services
and the GP champions have assisted with
this in some areas
• Empower women to ask about LARC
• Dispel the myths and separate the
financial barriers to LARC
References
The London Sexual Health Programme
• Faculty of Sexual and Reproductive
Healthcare www.fsrh.org
• NICE – Long acting reversible
contraception (2005) www.nice.org.uk
• Royal College of Nursing (2011)
Intrauterine techniques (IUT)
www.rcn.org.uk
• Royal College of Nursing (2011) Inserting
and removing SDI www.rcn.org.uk
References
The London Sexual Health Programme
• London Sexual Health Programme
www.londonsexualhealth.org
Nurses and LARC
• Thank you all
• [email protected]