PRAXIS:  "The action and reflection of people upon their world in order to transform it."

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Opportunistic Chlamydia Testing: Improving Nursing Practice Through Self-Audit and Reflection

Rose Stewart, RGON, ADN, PG Cert in Child & Family Health, Family Planning Nurse, Margaret Sparrow Centre, Wellington

Stewart, R. (2005). Opportunistic chlamydia testing. Improving nursing practice through selfaudit and reflection. Nursing Praxis in New Zealand, 21(1), 43-52.

Abstract

This article details how an individual family planning nurse’s practice concerning opportunistic testing for sexually transmitted chlamydia was improved through an audit of her testing rates and reflection on the outcome. The leading curable sexually transmitted infection in New Zealand, chlamydia, (including the incidence and spread of the infection and why it is a public health issue) is discussed, and the audit examined. The first audit of fifty consecutive client visits exposed a lack of opportunistic testing. The second looking at a similar but more recent group of client visits, made after the results of the first (zero opportunistic testing) were known, shows an increase in testing and education about chlamydia. Important clinical issues concerning chlamydia testing and treatment are considered. In conclusion the article challenges other nurses in the community to take a lead in raising awareness of the consequences of undiagnosed chlamydial infection and find ways of increasing opportunistic testing for chlamydia within their practice.

Key Words: Chlamydia, opportunistic testing.

Introduction
Chlamydia is an important public health issue and as a silent infection with serious sequelae for women is an important issue for nurses promoting adolescent health and those who encounter infertility and ectopic pregnancy in their practice. The scope of a Family Planning nurse’s practice is centred around contraception and sexual health issues. Cervical screening and testing for sexually transmitted infections (STI) form a large component of practice. This article discusses the lack of opportunistic testing by a nurse in a Family Planning Clinic (FPA), a situation which was exposed through a simple self auditing process which enabled an improvement in practice to be made. Reflection on that process, identifying the barriers to testing follows, and issues to consider when carrying out opportunistic testing are outlined.

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