1 Sample Takers 2014 Cervical Sample Taker Training Quality IssuesCervical Sample Taker TrainingSouth West Regional Cytology Training Centre1
2 Quality AssuranceThe NHSCSP is one of the best quality assured screening programmesQA guidelines cover all aspects of the programme
3 Limitations of Cervical Screening No screening test can provide 100% protectionNon-attendanceSampling errorScreening errorInterval cancers
4 Samples Ensure correct patient/details Good quality sample (Good technique & Audit)Result must be back to patient within 2 weeks
5 How to measure sample quality? Monitor inadequate samplesMonitor whether samples contain evidence of transformation zone sampling
6 Possible reasons for inadequate samples Excess BloodMenstrual samplesLarge ectropionExcess mucusAtrophic cervixLubricantPoor sampling technique/sample transferShould all be covered during practical session
8 Transformation Zone Sampling It is important that the TZ is sampled as this is the area where abnormalities may arise
9 Transformation Zone Sampling A sample does not have to have TZ material to be called negativeWhy do some samples not contain TZ material?Position of TZ in post-menopausal womenPoor sampling?
10 Transformation zone sampling Audit of TZ gives an indication of the quality of your sample takingIn women aged 25-50, 80% of samples should contain evidence of TZ samplingThis is your target during training periodMust see reports of all samples taken
11 Auditing Quality Sample Taker 1 : Inadequate rate 0% Who would you rather took your sample?Sample Taker 1: TZ sampling 30%Sample Taker 2: TZ sampling 85%Unless they audit TZ sampling, sample taker 1 thinks they are doing a brilliant job
12 Transformation zone sampling This audit will be done for you during your training periodYou should continue to audit this once qualifiedHow?
13 TZ sampling – Bath Feedback sheets TZ listed as Y, N or PM (postmenopausal)Reports:Adequate cellular content. TZ cells presentAdequate cellular content. TZ cells absentPM: adequate cellular contentInadequate: Unsatisfactory
14 Assessment of TZ sampling - Southmead Laboratory Sample quality codes located towards the bottom of the report form indicate presence or absence of TZ samplingUsually 2 digits
20 Sample taker registerDifferent areas have separate sample taker registersOutside BNSSG?Check with your local laboratory about obtaining a sample taker code asapBristol sample takers:Please register before taking a sample at: nww.avon.nhs.uk/phnet/cervical.htmUpon registration a unique sample taker code is issuedInform register if you move practices (keep code unless you move out of Bristol)
24 Sample Taker Register Monitor initial training & update training Sample Taker ProfilesBristol: Updated annually onto CTC websiteNo. of samples takenNo. of inadequatesNo. samples with TZ sampling (work out %age)Bath: Need to request information from labBest practice is on-going self-audit