‘I think it is better for practice nurses to do that.’ Findings from the Australian Chlamydia Control Pilot (ACCEPt).
Chlamydia infection is an important public health issue for young people, yet testing rates in Australian general practice are low. ACCEPt, a large cluster randomised control trial of annual testing for 16 to 29 year olds in general practice, is the first to investigate the role of practice nurses (PN) in maximising testing rates. We aimed to determine the current role of PNs, their opinions in relation to taking a role in chlamydia testing and the perceived facilitators and barriers to testing.
Structured in-depth telephone interviews were conducted with a purposive sample of 25 PNs participating in ACCEPt. PNs described a wide and varied role, with other clinic staff viewing them positively as a “link” between the doctors and other clinic staff. PNs identified a number of patient benefits to them becoming involved in chlamydia testing, such as an improved service with greater access to testing and feeling more comfortable engaging with a PN rather than a doctor. An alleviation of doctors’ workloads and expansion of the PN role were also identified as benefits at a clinic level. Time and workload constraints were commonly considered as barriers to chlamydia testing, both generally and for PNs, along with concerns around privacy in the “small town” rural settings of many of the clinics. Some PNs felt a lack of support from doctors as well as issues with funding for PN work could also be barriers. The provision of training and education and changes to pathology ordering processes would facilitate PN involvement in chlamydia testing, whilst some identified the development of a “formal” system of chlamydia testing, both on a clinic and national level, as facilitators.
PNs want to be involved in chlamydia testing and identify benefits in doing so. Strategies to facilitate their involvement and overcome identified barriers must be explored.
