A service-based approach to nurse training in sexual and reproductive health care.

AIMS: To develop and pilot a reproducible curriculum for nurses with limited or no sexual and reproductive health care (SRH) experience to become competent dual-trained practitioners. The model used supernumerary training posts and clinical training and assessment adapted from that used to train doctors for the Diploma of the Faculty of Sexual & Reproductive Healthcare in the UK. BACKGROUND: There is currently no standard SRH nurse training in the UK. Nurses undertake various university-based qualifications supported by clinical sessions, and employers can be reluctant to sponsor these because of the cost and the time required. METHODS: Two nurses were employed on a 6-month programme consisting of five parts: (1) the Faculty of Sexual & Reproductive Healthcare (FSRH) e-learning programme, in conjunction with e-Learning for Healthcare; (2) the FSRH 'Course of 5'; (3) structured clinical training; (4) visits to other relevant services; and (5) clinical supervision and mentoring. Assessment was by a portfolio of evidence; signed competences; reflections from clinical sessions; and outcomes of visits to services. The project was evaluated by means of questionnaires and interviews with trainees and staff. CONCLUSIONS: The project demonstrated that by using a model similar to that used for basic SRH medical training it is possible to train nurses in core holistic SRH care within the workplace. Many SRH services are reporting severe difficulties in the recruitment of nurses trained in SRH, and this practice-based training would allow services and providers to invest in training to build up the workforce they require.

Comparing doctor- and nurse-led care in a sexual health clinic: patient satisfaction questionnaire.

BACKGROUND: A new model of comprehensive care nurse-led clinics has enabled experienced genitourinary medicine nurses to co-ordinate the first-line, comprehensive care of female patients presenting with sexually transmitted infections and other sexual health conditions and issues. AIM: This paper describes the development of a patient satisfaction questionnaire to compare the satisfaction of women attending nurse-led or doctor-led clinics at a central London genitourinary medicine clinic. METHODS: A previously validated questionnaire was adapted using the findings of qualitative interviews exploring patient expectations of the service. The draft questionnaire was tested for internal consistency, sub-scale homogeneity, construct validity and stability. The final version consisted of a 34 item, five-point Likert scale, which was found to be both reliable (Cronbach's alpha 0.91) and stable (test-retest 0.95). There was some evidence of construct validity. The questionnaire was then distributed to a convenience sample of 132 women attending a nurse-led clinic and 150 seen at a doctor-led clinic. RESULTS: There was a 90% response rate. The median total satisfaction scores, out of a total of five, were 4.47 and 4.30 for the nurse-led and doctor-led groups, respectively (P = 0.05). Significantly higher scores on the sub-scales measuring quality and competence of technical care (P < 0.001), provision of information (P = 0.01) and overall satisfaction (P = 0.01) were seen for the nurse-led group. No significant differences were found in the sub-scales measuring service attributes and specific attributes of interpersonal relationships. CONCLUSION: The rigorous development, piloting and testing phases of this satisfaction questionnaire led to reliable and valid results. This study demonstrated that nurse-led clinics within this service are an acceptable alternative to the existing doctor-led clinics.