A Nurse Practitioner Led Model of Care for Colposcopy Services
Nurse practitioners in New Zealand are providing high quality, cost effective women’s health care.
Advanced nursing practice in women’s health has been well established internationally for more than 30 years. Georgina McPherson, a Nurse Practitioner (NP), developed the first nurse colposcopist training programme in New Zealand with Professor Ron Jones at the National Women’s Hospital, Auckland. She has been practising as a colposcopist for 18 years and in 2006 was endorsed as the first nurse practitioner (NP) in Women’s health.
Georgina was the first nurse of Pacific descent to gain NP endorsement in New Zealand. Her practice has spanned both primary and secondary care services, providing colposcopy and previously a well women’s clinic in the community to improve access to care for Maori and Pacific women.
In New Zealand NPs have been clinical experts within teams, and as the role has developed, they are now becoming clinical leaders of teams. Recognition of the quality of service provision by NPs led to Georgina being appointed as the clinical lead in 2016 with the approval of the New Zealand Ministry of Health. This role had hitherto been designated as a role for medical practitioners.
Georgina’s scope of practice in the clinical context spans women’s health, including:
- Diagnostic colposcopy of the lower genital tract
- Treat and manage vulval conditions, including dermatological conditions
- Training to perform Large Loop Excision of the Transformation Zone procedures under local anaesthetic
- Manage sexual and reproductive health issues including contraception and gynaecological issues within her scope of practice
- Involvement in developing a multidisciplinary pelvic pain service in which NPs will provide advanced clinical assessment, treatment and management of women referred to gynaecology services with pelvic pain
Georgina is well recognised as a leader in her field providing frontline clinical care services that are exceling above the Colposcopy Quality Improvement Programme standards, and providing exceptionally high quality of care.
Seeing some of the issues with access to services in her community, Georgina established a new clinical pathway.
A laboratory utilisation project saw evidence-based guidelines implemented and a significant and sustained change in laboratory testing. This resulted in savings of close to $100,000 over a 12-month period and has reduced unnecessary testing for women.
The NP led model of care has demonstrated NPs can provide a clinically and cost-effective care. There has been a reduction in cancelled clinics due to the flexibility of NP to cover. It has also allowed the development of NPs into other areas of the gynaecology service. The development of a NP as a clinical lead has shown NPs can provide excellent clinical leadership and lead clinical services to improve quality of care and service provision.