Nurses Provide High Quality Pap Tests

Nova Scotia women are receiving high-quality care from specially-trained registered nurses and nurse practitioners who perform Pap tests, according to Cancer Care Nova Scotia's Gynaecological Cancer Screening Program.

The screening program sends personalized specimen adequacy reports each year to 12 nurse practitioners and 26 specially-trained registered nurses who perform Pap tests. The 2003 report cards, the most recent available, indicate an average satisfactory rate of 99.6 per cent. This is the same satisfactory rate reported for family doctors.

"Nurse practitioners and specially-trained registered nurses who administer Pap tests are providing Nova Scotia women with excellent care," said Dr. Robert Grimshaw, medical director of the screening program. "The report cards also show that 51 per cent of women they reached in 2003 had not had a Pap test in three years or more. Their efforts in reaching these unscreened women will help to decrease the incidence of cervical cancer in Nova Scotia."

The screening program provides education materials for nurses who wish to be specially trained and outlines the skill levels they recommend nurses attain. The training program includes a self-directed learning module, a one-day theory and practical skills training session, and practical hands-on experience with a physician. The length of the practical experience component is dependent on the skill level of the nurse.

In addition, the screening program recommends that nurses meet re-certification criteria annually. This includes: performing a minimum of 20 Pap smears per year; and having an unsatisfactory smear rate of not more than one per cent for women equal to or less than 50 years of age, and not more than two per cent for women more than 50 years of age. By providing nurses with education materials and recommended re-certification criteria, and by consistently monitoring the quality of Pap tests, the screening program is ensuring that Nova Scotia women continue to receive high quality screening for cervical cancer.

"Regular Pap tests are so important, particularly considering the high rate of cervical cancer in Nova Scotia," said Priscilla Sharkey, clinical practice development nurse/educator, Pictou County Health Authority. "The service that specially-trained registered nurses and nurse practitioners provide to women is invaluable as it increases awareness and access for this important screening measure."

When screening Pap tests, Cytology laboratories evaluate each test as satisfactory, satisfactory but limited by a specific problem, or unsatisfactory. This detailed information is sent to the screening program for entry into its data registry. Specimen adequacy reports for each specially-trained registered nurse and nurse practitioner are created from this data.

A Pap test must meet certain specifications before it can be considered satisfactory. The cells must be gathered from an area of the cervix known as the transformation zone, where abnormal or pre-cancerous cells can appear. Because gathering these cells becomes more difficult as women age, the report cards have one set of data for women aged 50 and under, and another for women above the age of 50.

Any nurse practitioner or specially-trained nurse providing Pap tests in Nova Scotia can obtain their personal report card from the screening program by registering at 1-888-480-8588.

The Gynaecological Cancer Screening Program is dedicated to decreasing the incidence of gynaecological cancer in Nova Scotia. Initial efforts focus on cervical cancer and are aimed at prevention, early detection and appropriate management.

Regular Pap tests can prevent 90 per cent of deaths from cervical cancer. The screening program recommends that all women, aged 18 years and older, have regular Pap tests. Women under 18 should also have regular tests if they are sexually active.

Cancer Care Nova Scotia is a program of the Department of Health, created to reduce the burden of cancer on individuals, families and the health-care system through prevention, screening, education and research.