Practice nurse chlamydia testing in Australian general practice: a qualitative study of benefits, barriers and facilitators

Abstract

BackgroundChlamydia infection is a significant public health issue for young people; however, testing rates in Australian general practice are low. Practice nurses (PNs) could have an important role in contributing to increasing chlamydia testing rates. The Australian Chlamydia Control Effectiveness Pilot (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 PNs in maximising testing rates. In order to assess the scope for PN involvement, we aimed to explore PN’s views in relation to involvement in chlamydia testing in general practice.MethodsSemi structured interviews were conducted between June 2011 and April 2012 with a purposive sample of 23 PNs participating in ACCEPt. Interview data was thematically analysed using a conventional content analysis approach.ResultsThe participants in our study supported an increased role for PNs in chlamydia testing and identified a number of patient benefits from this involvement, such as an improved service with greater access to testing and patients feeling more comfortable engaging with a nurse rather than a doctor. An alleviation of doctors’ workloads and expansion of the nurse’s role were also identified as benefits at a clinic level. Time and workload constraints were commonly considered barriers to chlamydia testing, along with concerns around privacy in the “small town” rural settings of the general practices. Some felt negative GP attitudes as well as issues with funding for PNs’ work could also be barriers. The provision of training and education, streamlining chlamydia testing pathways in clinics and changes to pathology ordering processes would facilitate nurse involvement in chlamydia testing.ConclusionThis study suggests that PNs could take a role in increasing chlamydia testing in general practice and that their involvement may result in possible benefits for patients, doctors, PNs and the community. Strategies to overcome identified barriers and facilitate their involvement must be further explored.

Barriers and Facilitators of Partner Treatment of Chlamydia: A Qualitative Investigation with Prescribers and Community Pharmacists

“…The key barriers and facilitators to the standard partner therapy model (as shown in Figure 1 ) identified in this study were relatively consistent with existing national and international literature which have explored GP and NP views on chlamydia testing [ 29 , 30 , 31 , 32 ]. A major barrier faced by prescribers is sexual partners’ deprioritizing of the need for testing and, therefore, they remain untreated.…”

Service evaluation of an educational intervention to improve sexual health services in primary care implemented using a step-wedge design: analysis of chlamydia testing and diagnosis rate changes

“…Following CIRT, and in line with other interventions [ 25 ], 3Cs&HIV training emphasises the inclusion of all general practice staff in training [ 20 , 35 ]. The intervention effect differed depending on the number of GPs employed but not nurses.…”

A systematic review of experiences of advanced practice nursing in general practice

“…A review by McInnes et al [11] and a study by Merrick et al [12] provided worthwhile understandings of challenges to teamwork, collaboration and decision-making in the general practice environment without specifically tackling issues surrounding advanced practice nursing. Other studies focused on nurses performing certain roles [13, 14], working in specific contexts [10, 15], or managing particular illnesses [16–18]. …”