An audit reviewing Intrauterine contraceptive fitting

Published Date: 10th October 2016

Publication Authors: , Annuar N, Botchey SA

​Objectives

To ensure that contraceptive fitting at a community sexual health clinic meets the auditable standards suggested by the FSRH clinical standards committee. Standards (FSRH clinical standards committee auditable outcomes) (1) The proportion of sexually active women offered sexually transmitted infection screening requesting intrauterine contraception (IUC). [Auditable standard 97%] (2) The proportion of women who had a pelvic assessment either by bimanual examination or ultrasound scan before insertion of IUC. [Auditable standard 97%] (3) An appropriately trained assistant should be present during insertion of IUC. [Auditable standard 97%] 

Methods

The Lillie electronic patient record system was used to collate the data of all patients who attended the St Helens sexual health clinic for intrauterine contraceptive insertion between 15 January and 15 February 2015. In total 33 patient records were found, however three patients were excluded due a last minute change in mind of coil insertion therefore 30 patients in total were analysed. A Microsoft Excel spreadsheet was constructed in which the following was recorded by the authors: age, prior method of contraception, type of intrauterine device, offer of an STI test prior to insertion, bimanual/pelvic assessment performed; before insertion and presence of a trained assistant at insertion.

Results

The age range of the patients was 15-48 years and the most common form of prior contraceptive method was a condom. Overall, 90% of women had the copper (IUD) inserted and 30% had the Mirena coil (IUS) inserted. Audit Standard 1: 83% of women requesting intrauterine contraception were offered a sexually transmitted infection screening. Audit Standard 2: 100% of women had a pelvic assessment either by bimanual examination or ultrasound scan before insertion of IUC. Audit Standard 3: 80% of women had an  appropriately trained assistant present during insertion of IUC. 

Conclusions

Audit standard 2 was met with a figure of 100%, however, audit standard 1 and 3 were not met. Though audit standards 1 and 3 reached 80% and beyond, improvements are still needed in these areas to meet the auditable standards of 97%. The following recommendations were made to improve standards. 1. Update trust guidelines to include the three auditable standards as recommendations. 2. Reminders to encourage all responsible personnel to offer an STI screen (via poster format or having a pop up on the Lille medical records system). 3. Encouraging and offering more staff training for intrauterine contraceptive insertion.

Friday, D; Annuar, N; Botchey, SA. (2016). An audit reviewing Intrauterine contraceptive fitting at a community contraceptive clinic . European Journal of Contraception and Reproductive Health Care. 21 (Suppl 1), 112.

« Back