1. Sample Takers 2014 Cervical Sample Taker Training
Quality Issues
Cervical Sample Taker Training
South West Regional Cytology Training Centre 1

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%
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 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

16. Southmead Lab - TZ sampling11
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

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