Nurses well placed to undertake contraceptive implant procedures

New research from Family Planning NSW has confirmed nurses are well placed to perform contraceptive implant procedures, and this would have a positive impact on clinical service delivery and increase contraception access.

The paper, Training nurses in contraceptive implant procedures: implications for practice in Australia, published in Collegian: The Australian Journal of Nursing Practice, Scholarship and Research, contributes to the growing literature on nurse-led implant procedures in Australia and globally.

The contraceptive implant (Implanon NXT) is a long-acting, reversible contraceptive (LARC) which can last up to three years. It is small, flexible rod inserted under the skin of the upper inner arm where it releases progestogen and is 99.95% effective at preventing pregnancy.

Uptake of the implant is low in Australia, with the pill and condoms still more commonly used. According to Kirsteen Fleming, FPNSW Acting Director of Clinical Operations, women may have greater contraceptive choice and access if more nurses were supported to undertake implant insertion and removal training.

"Our research showed that nurses, when provided with appropriate training and support, felt confident in providing contraceptive implant counselling, insertion and removal," Kirsteen said.

"Nurse-led implant insertions are commonplace internationally where LARC use is higher, but in Australia this procedure is predominantly provided by doctors.

"There are growing calls for nurses to contribute to LARC procedures in Australia, which could really help shift the dial on LARC uptake and allow women increased choice and access to contraception options."

The study involved a small group of Registered Nurses from Family Planning NSW who undertook training and supervised assessment in the clinical setting.

The training program was developed collaboratively between expert clinicians and educators and drew on the standard criteria outlined in 'The safe and effective insertion and removal of Implanon NXT by health care professionals in Australia'.

The nurses involved in this study felt that the training and acquisition of this new skill would have a positive impact for their work, due to enhanced knowledge, increased scope of practice, and ability to offer this procedure to their patients.

"Having nurses provide these services would reduce the workload of GPs, allow opportunities for task sharing and increase women's access to contraception," Kirsteen said.

"This could be particularly beneficial for young women and women living in rural and remote areas who may find it more difficult to access all contraceptive options."

However, while the benefits of having nurses insert and remove contraceptive implants are evident, Medicare rebates in Australia primarily only subsidise doctor-led services.

"There is currently no provision for nurses or midwives to provide services or claim for LARC procedures through the Medicare Benefits Scheme in Australia," Kirsteen said.

"These funding constraints remain a significant barrier for nurses to provide these additional services, even if trained to do so, so exploration of appropriate funding models is necessary."

"From our research, and from the national and international literature available, we know that Registered Nurses, as well as Nurse Practitioners and Registered Midwives, are well placed to undertake contraceptive implant procedures in Australia.

"Facilitating increased access to training and nurse-led insertions through supportive policies and funding options could see more nurses able to provide implant insertions to clients and ultimately support increased choice and access for women."

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Media enquiries:

P: 0402 880 653

E: media@fpnsw.org.au

W: https://www.fpnsw.org.au/

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