ABSTRACT
A recent publication of an evidence-based clinical guideline for male and female sterilisation by the Royal College of Obstetrics and Gynaecology (RCOG) created a stimulus for a review of our female sterilisation service. We arranged for a gynaecology nurse-practitioner (A.O.) with extensive experience in general gynaecology and contraception to undergo additional training in counselling female sterilisation. She then took over the daily running of the sterilisation clinic using a care pathway and pre-printed letters. She had open access to a consultant (R.F.) for advice. A review of 100 consecutive referrals showed that the nurse followed the guidelines extremely closely both in terms of referral to the medical team for advice and/or further counselling and quality of documentation. A total of 59% of the women attending the clinic were cared for by the nurse-practitioner alone. Only four had to see a consultant. All women questioned expressed very positive comments about the style and content of counselling and just one stated she preferred to see a doctor.
Subject(s)
Directive Counseling/organization & administration , Family Planning Services/organization & administration , Gynecology , Nurse Practitioners , Sterilization, Reproductive/nursing , Female , Humans , Nurse's Role , Patient Satisfaction , Program EvaluationABSTRACT
Both posterior colpotomy with associated fimbriectomy and laparoscopy offer rapid and effective methods for carrying out interim and post-abortion tubal sterilization. They can effectively be performed on an out-patient basis. Posterior colpotomy has the added advantage that it can be conveniently performed under a combination of intravenous neuroleptanalgesia and local vaginal anesthesia. This series exemplifies the manner in which the burden upon hospital facilities and medical and paramedical personnel can be minimized. In addition, utilization of the "home-care program" has improved patient acceptance and convenience.
