Community-based vasectomy services: from medical to holistic care

Community-based vasectomy services: from medical to holistic care

K. McAllister

The Sandyford Initiative, Glasgow, UK

Introduction: The vasectomy service within the Sandyford Initiative,

Reproductive and Sexual Health Centre, Glasgow has traditionally been

medically-led, with medical staff performing both the counselling and operating

sessions. It was felt that the service could be more holistically driven, by

improving the surroundings and increasing the input from family planning nurses.

Method: Five designated FP nurses attended in-house training, to give

them an overview of the procedure, it’s complications and failure rates and

completed a short supervised practice session prior to staffing individual

clinics. The nurses counselled the client and obtained written consent, but did

not perform scrotal examination. ‘De-medicalisation’ during the procedure

itself was also improved with background music and, after consultation with the

Trust infection control team, green operating gowns were replaced with plastic

aprons and no masks were worn. Clients were audited during a one-month period

for their views on the counselling and operative visit.

Results: 66 attended for counselling all of which completed

questionnaires (100%). All reported the reception and counselling staff to be

courteous with the length of appointment (20 mins) adequate and the information

given comprehensive. 43 had a female nurse counsellor and all felt comfortable

with this. 85 attended for vasectomy and all completed questionnaires (100%). 83

felt the counselling prepared them for the procedure with 27 stating the

discomfort was as expected, 53 less and 5 worse than expected. All clients who

wished background music (30) felt it was useful in distracting them but only 4

of the 23 clients who chose not to have background music felt afterwards that it

may have been useful. 5 clients asked for their partners to be present and this

was agreed by the surgeon involved.

Conclusion: It is possible to provide a more holistic vasectomy

service without compromising on the level of medical care received. The

introduction of a nurse led vasectomy counselling service in a holistic setting

led to a high level of client satisfaction.

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