Insertion of intrauterine contraceptive devices by registered nurses in Australia.

Abstract

In spite of many advantages, intrauterine contraception (IUC) is underutilised in Australia: only 5% of Australian women using contraceptive methods in 2011 were using IUC. In 2012, Family Planning New South Wales (FPNSW) commenced training registered nurses (RNs) to insert IUC. This article reports outcomes of insertion attempts by the first four trained RNs and suggests strategies for increasing IUC utilisation in Australia. Data regarding client characteristics and outcomes of insertion attempts, including relevant adverse events that occurred during a 6-month follow-up period after the IUC insertions, were retrospectively extracted from the FPNSW clinical record system and analysed in SPSS. Of 207 insertion attempts by RNs, 91% were successful without Medical Officer (MO) assistance. The likelihood of insertion attempts being successful did not differ significantly between nulliparous and parous clients. Incidence of a postinsertion adverse event was equal to or less than rates in previous studies. All adverse events involved parous clients. We have shown that RNs who undertook competency-based IUC insertion training had a high rate of successful insertions and a low rate of adverse outcomes. Utilisation of IUC in Australia could be increased by engaging RNs as inserters, and it is timely to review the barriers that make it difficult for private medical services to employ RNs to insert IUC.