Cervical
screeningCervical smears are taken to detect pre-cancer and has been shown to reduce both the incidence and mortality from cervical cancer.
Aims
- To understand the anatomy and physiology of the pelvic organs.
- To be able to take an adequate sample of endo-cervical cells, with minimum discomfort or embarrassment to the patient.
- To be able to discuss the reasons and outcomes from the smear.
- To ensure correct labelling of specimen and forms, and safe transport to the laboratory.
- Maintain a record of smears taken and ensure an accurate call, recall system and notification of results.
- To understand the health and safety issues.
Procedure
- Welcome and check identity of woman, ensure privacy.
- Give explanation and answer any queries, gain informed consent.
- Take history - menstrual, smear history, contraception or HRT use.
- History of problems, unusual bleeding, discharge, urinary symptoms.
- Fill in form accurately and clearly with a biro.
- Label transport medium container with name and D.O.B.
- Select suitable sized speculum, put on gloves.
- Ask patient to undress behind screened area and lie on bed, covered with blanket.
- Ask patient to bend her knees, while keeping her feet together.
- Insert warmed speculum and visualise cervix, assess and interpret.
- Place cytology brush in os, and sweep round the whole of the transformation zone, including margins.
- Transfer cells to approprate transport media (see local guidelines)
- If abnormal discharge take appropriate swabs
- Explain and refer on if any problems e.g. cervical polyps
- End consultation, explain result procedure and outline possible results with mention of possibility of repeat smear. Offer further discussion if required.
- Complete any forms
- Update computer
- Wash and sterilise equipment
References
- Resource Pack for Training Smear Takers (1998) National Health Service Cervical Screeing Programme, Sheffield
- Paniagua, H (1999) Take a Cervical Smear. Practice Nursing. Vol 10 No 16 p 16 - 19