Should Home-Based Contraceptive Dispensing become a Routine part of Public Health Nurse Practice? Review of Nurse Perceptions.

OBJECTIVE: We examined public health nurses' beliefs about the safety of dispensing hormonal contraceptives in the home, the extent to which they considered contraceptive dispensing within their scope of practice, and the types of support needed to effectively dispense contraceptives in the home. DESIGN AND SAMPLE: We conducted focus groups in Washington State with 24 home visiting nurses participating in a Nurse Family Partnership (NFP) randomized clinical trial in which nurses dispensed hormonal contraceptives during home visits. MEASURES: We assessed the feasibility of the intervention and barriers and facilitators to home dispensing of hormonal contraceptives. RESULTS: Nurses were, on average 52 years old and had been working in nursing approximately 25 years, with between 5 and 18 years of experience working in a family planning setting. Overall, nurses believed that, with the right training and support, dispensing of hormonal contraceptives in the home was safe and fit within their scope of practice. Those nurses who reported resistance to the intervention cited inadequate training, lack of clear protocols, and sufficient support as important deterrents. CONCLUSIONS: Home-based contraceptive dispensing by nurses is a feasible enhancement of the NFP program. To ensure that nurses are confident and able to dispense hormonal contraceptives, training, clinical protocols, consultation, and logistical support are needed.

Education and practice: dynamic partners for improving cultural competence in public health.

This article reports on a collaborative project linking Washington State University College of Nursing Vancouver and Southwest Washington Health District. Designed to improve the cultural competence and public health skills of registered nurses who are baccalaureate student nurses, quantitative and qualitative evaluative analyses were used to document and describe themes and strategies. The Inventory to Assess the Process of Cultural Competence Among Healthcare Professionals (IAPCC) was useful in measuring the students' progress toward cultural competence, and significant changes were documented. Themes that lead students toward population-focused nursing practice were uncovered as well as barriers to the process of cultural competency.