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Quality Issues Cervical Sample Taker Training. Quality Assurance The NHSCSP is one of the best quality assured screening programmes QA guidelines cover.

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Presentation on theme: "Quality Issues Cervical Sample Taker Training. Quality Assurance The NHSCSP is one of the best quality assured screening programmes QA guidelines cover."— Presentation transcript:

1 Quality Issues Cervical Sample Taker Training

2 Quality Assurance The NHSCSP is one of the best quality assured screening programmes QA guidelines cover all aspects of the programme

3 Limitations of Cervical Screening No screening test can provide 100% protection Non-attendance Sampling error Screening error Interval 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 samples Monitor whether samples contain evidence of transformation zone sampling

6 Possible reasons for inadequate samples Excess Blood Menstrual samples Large ectropion Excess mucus Atrophic cervix Lubricant Poor sampling technique/sample transfer Should all be covered during practical session

7 Auditing the quality of your samples

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 negative Why do some samples not contain TZ material? Position of TZ in post-menopausal women Poor sampling?

10 Transformation zone sampling Audit of TZ gives an indication of the quality of your sample taking In women aged 25-50, 80% of samples should contain evidence of TZ sampling This is your target during training period Must see reports of all samples taken

11 Auditing Quality Sample Taker 1 : Inadequate rate 0% Sample Taker 2: Inadequate rate 2% Who would you rather took your sample? Sample Taker 1: TZ sampling 30% Sample Taker 2: TZ sampling 85% Who would you rather took your sample? 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 period You should continue to audit this once qualified How?

13 TZ sampling – Bath Feedback sheets TZ listed as Y, N or PM (postmenopausal) Reports: Adequate cellular content. TZ cells present Adequate cellular content. TZ cells absent PM: adequate cellular content Inadequate: 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 sampling Usually 2 digits

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16 Southmead Lab - TZ sampling 11 First digit - refers to TZ sampling 0 = no TZ cells 1 = TZ cells present

17 Squamous cell content 11 Second digit - refers to squamous cell content 0 = Insufficient squamous cells 1 = Sufficient squamous cells

18 Reprocessed samples (2 slides made from one sample) 5 digits will be seen: 00411 TZ slide 2 Background material

19 Sample Taker Registers

20 Sample taker register Different areas have separate sample taker registers Outside BNSSG? Check with your local laboratory about obtaining a sample taker code asap Bristol sample takers: Please register before taking a sample at: nww.avon.nhs.uk/phnet/cervical.htm Upon registration a unique sample taker code is issued Inform register if you move practices (keep code unless you move out of Bristol)

21 nww.avon.nhs.uk/phnet/cervical.htm

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23 Enter your details

24 Sample Taker Register Monitor initial training & update training Sample Taker Profiles Bristol: Updated annually onto CTC website No. of samples taken No. of inadequates No. samples with TZ sampling (work out %age) Bath: Need to request information from lab Best practice is on-going self-audit


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