1. Exemplars of Nursing & Midwifery Role Expansion HSE West

2. The Role of the Nurse Colposcopist. Regina Mc Cabe. MSc Nurse Colposcopist/CNS. Letterkenny General Hospital. February 2012

3. Background. Traditionally colposcopy has been a consultant led service. There was no formal training programme. Junior doctors were trained on an ad hoc basis. In 1996 the British Society Colposcopy & Cervical Pathology (BSCCP) introduced formal training for all colposcopists.

4. Career Pathway. 1999 in Ireland, the Minister for Health established the National Council for the Professional Development of Nursing and Midwifery (NCNM). A framework was created to monitor the ongoing development of nursing and midwifery specialities and a clinical career pathway was established (NCNM). 2002 in UK, Nursing & Midwifery Councils Code of Professional Conduct This allows nurses working in an extended role within colposcopy to access colposcopy training and accreditation.

5. Role Expansion: The Nurse Colposcopist A nurse who is trained, competent and certified to perform colposcopy in accordance with the training standards laid down by the …… British Society Colposcopy & Cervical Pathology/ Royal College of Gynaecology (BSCCP/RCOG). The aim of the BSCCP/RCOG colposcopy training programme is to enable trainees to obtain the core knowledge, develop the necessary skills and the personal and professional attributes to enable competency in colposcopy. Final assessment/examination Objective Structured Clinical Examination (OSCE). Visit 12 station OSCE with 10 minutes examination at each station. The training of the Nurse/Midwife Colposcopist is identical to that of their medical colleagues.

6. . Development of New Skills/ Competencies. Nurse/Midwife Colposcopists undergo the same audit requirements and continuing education as their medical colleagues. All Colposcopists require to see a minimum of 50 new patients each year. All Colposcopists must attend a Colposcopy related postgraduate meeting every three years. (BSCCP) Annual Scientific conference. Newcastle April 2012. Re-apply every three years to stay on the register. Pay an annual registration fee.

7. . Challenges & Supports. Year20072008/20092010 New Pts attended9,04312,30715.759 Treatments2,5044,7146,711 Currently there are in excess of 15,000 women who require a colposcopy examination in Ireland each year. CervicalCheck…. The National Cervical Screening Programme became available to over 1.1 million eligible women on Sept 2008. Free smear tests to women aged 25 to 60 years. Aim of cytology screening to identify and treat cervical abnormalities before they become cancerous.

8. . Benefits. With the introduction of.. National Cervical Screening Programme + Full time Nurse/Midwife Colposcopists, Waiting lists in Colposcopy have been abolished. 1482 women on waiting list 2009 Zero women on waiting lists 2012

9. The Nurse Colposcopist Nurse Colposcopist, Assess, examine, diagnose, treat & discharge patients. Currently there are 15 fully certified Nurse Colposcopists in Ireland. 15 Colposcopy services/ clinics nationwide to support the needs of the CervicalCheck programme

10. Colposcopy at Letterkenny General Hospital. 1,730 women attended in 2010. 2,266 women attended in 2011.

11. Advantages of the Nurse Colposcopist. Patient Centred Care. Multidisciplinary approach to care. Continuity of care. Flexibility of clinic times. Greater involvement & personal satisfaction. Skilled Colposcopists provide specialised care & management which results in; Increased patient choice. Improved patient contact.

12. Evaluating Quality Professionals Professionals o Delivering effective care o Practice. o Training. o Accountability. Patients Patients o Access to care. o Emotional support. o Physical comfort.

13. COLPOSCOPY PATIENT SATISFACTION SURVEY Environment Patient experience Information given at time of appointment Privacy and Dignity Information post Colposcopy

14. Thank You For your courtesy in waiting, You too will receive the same careful attention. You too will receive the same careful attention.

15. Current role in Colposcopy Perform 5 diagnostic clinics a week Nurse led cytology clinic per week Nurse counsellor to colposcopy patients Clinical supervisor for trainees undertaking the cytology course with CervicalCheck Clinical advisor to student nurses, trainee doctors, NCHDs & doctors on GP training course

16. Aim….. To deliver a Quality Service. Being open about the strengths & weaknesses of our service. Being determined to improve. Going Forward….. Advanced Nurse Practitioner in Colposcopy.

17. Go raibh maith agaibh, a chairde.