Chaperoning

A chaperone is a is an impartial observer present during an intimate examination of a patient. Health care practitioners should offer the patient the option of having a chaperone present (Dougherty and Lister, 2015). The person acting as a chaperone will need to have been DBS checked to ensure the safety and in the best interest of the patient. The decision regarding whether to have a chaperone present or not should be clearly documented. Information about the right to have a chaperone should be detailed in patient leaflets and information sources such as websites so that the patient can make an informed choice about having a chaperone. The age of the patient should also be considered as well as the nature of the procedure as well as the patient’s mental capacity to be able to make these decisions and should also be considered in line with the Mental Capacity Act

The healthcare professional should communicate with the patient and inform them of their right to have a chaperone during the procedure. The use of a chaperone should be clearly documented as well as if the patient declines the offer to have a chaperone.

The chaperone should usually be a health professional (Royal College of Nursing, 2020a).

The chaperone must:

• Be respectful and sensitive and be present for the whole procedure
• explain the procedure and assess the understanding of the patient if they are a healthcare professional
• Maintain and respect patients’ dignity and privacy
• Provide reassurance for the patient throughout the procedure in particular if they show signs of distress or discomfort
• Be prepared to raise concerns if they are concerns about any behaviour or action during the procedure
• Be sensitive to the cultural and religious issues and the patient’s needs
• Be aware that chaperones are to protect both patients and

The care location must ensure that a chaperone policy is in place and that staff who act as chaperones have specific training to be able to do so and understand the role that they are being asked to do.

If the chaperone is not utilised this can create risks for both the patient and the health care professional. The patient can be placed in a vulnerable position and the healthcare professional can be open to complaints and allegations of inappropriate examination, raising legal and ethical issues.

Staff who act as chaperones should have received training to provide them with the skills required to act as a chaperone. If staff are not properly trained to act as chaperones, they will be putting themselves at risk professionally (Nursing and Midwifery Council, 2018b). If there are any accusations made the nurse will be involved in litigation and may be asked to provide evidence in court. Record keeping is a fundamental skill in nursing practice, in this case it is crucial and may be used as evidence. Nurse chaperones need to be fully trained for the role and have clear policies and procedure to follow which will protect both the patients and their own nurse registration.

Staff undertaking the role should be aware of:

• What is a chaperone
• When may a chaperone be needed?
• What is an intimate examination/ procedure?
• What are the rights of the patient?
• The roles and

References

Dougherty, L, Lister, S. The Royal Marsden Manual of Clinical Nursing Procedures. (9th edn). Wiley Blackwell: UK; 2015.

legislation.gov.uk. Mental Capacity Act 2005. 2022. https://www.legislation.gov.uk/ukpga/2005/9/contents (access 28 November 2022)

Nursing and Midwifery Council. The Code. Professional standards of practice and behaviour for nurses, midwives and nursing associates. NMC; London. 2018a.https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf (accessed 28 November 2022)

Nursing and Midwifery Council . Standards of proficiency for registered nurses. 2018b. https://www.nmc.org.uk/globalassets/sitedocuments/standards-of-proficiency/nurses/future-nurse-proficiencies.pdf (accessed 28 November 2022)

Royal College of Nursing. Genital examination in women- A resource for skills development and assessment. 2020a. https://www.rcn.org.uk/Professional-Development/publications/rcn-genital-examination-in-women-pub007961 (accessed 28 November 2022)

Royal College of Nursing. Remote consultation guidance Under COVID 19 Restrictions. 2020b. https://www.rcn.org.uk/Professional-Development/publications/rcn-remote-consultations-guidance-under-covid-19-restrictions-pub-009256#:~:text=This%20guidance%20has%20been%20developed,or%20other%20remote%20consultation%20process (accessed 28 November 2022)

The Care Quality commission (CQC). GP Mythbuster 15: Chaperones. CQC. 2022. https://www.cqc.org.uk/guidance-providers/gps/gp-mythbuster-15-chaperones (accessed 28 November 2022)