Guidance for the training of cervical sample takers

Guidance for the training of
cervical sample takers
Topic 5: cervical screening sample requests
Note
Use these slides in conjunction with the NHS Cervical Screening Programme
publication ‘Guidance for the training of cervical sample takers’, available at:
www.gov.uk/government/publications/cervical-screening-cervical-sample-taker-
training
  2
Topic 5: cervical screening sample requests
Open Exeter
Open Exeter gives access to patient data held on the National Health
Application and Infrastructure Services (NHAIS) systems, which holds
information relating to cervical screening.
https://digital.nhs.uk/services/nhais/open-exeter
The programme recommends the Open Exeter web-based application
for all administration.
Open Exeter references data from the national call and recall system and
holds the master screening history records. This gives the cervical screening
laboratory immediate access to relevant data when reporting a test in order
to specify an appropriate next action. This in turn minimises the likelihood of
rejection of invalid test results by the call and recall system and reduces delays
in issuing results to people.
  3
Topic 5: cervical screening sample requests
Sample request forms (1)
Sample takers should use the pre-populated HMR101 cervical cytology request
forms (2009 version) available via Open Exeter.
Sample takers must:
know how to download the correct pre-populated HMR101 cervical cytology
request form (2009 version) from the Open Exeter application
be an authorised user and follow the guidelines for completion of the form
and produce the preferred size for the cervical screening laboratory
Failure to use Open Exeter forms may result in either delays due to the
laboratory checking the full history on Open Exeter or the risk of issuing an
inappropriate management recommendation by the laboratory.
  4
Topic 5: cervical screening sample requests
Sample request forms (2)
If a sample taker uses a non-Open Exeter request form for a legitimate reason,
for example, the patient is not yet registered or the Open Exeter system is
unavailable, they must provide an explanation on the non-Open Exeter request
form with the recent and relevant history.
Where laboratory electronic requesting systems are in use, there must be
mechanisms in place to provide the past screening history as it is on Open
Exeter. This ensures sample takers do not take unnecessary samples and that
laboratories are able to give correct patient management recommendations.
  5
Topic 5: cervical screening sample requests
Sample requirements
The sample taker is responsible for making sure a person is eligible for cervical
screening and due a test.
The sample taker takes the sample in the required manner and transfers into
the sample vial.
The sample taker sends the form and labelled vial on the same day to the
assigned cervical screening laboratory.
  6
Topic 5: cervical screening sample requests
Specimen rejection (1)
Cervical cytology samples must satisfy the minimum requirements for
processing and auditing.
www.gov.uk/government/publications/cervical-screening-accepting-samples-in-
laboratories
The laboratory rejects erroneous samples that compromise the safety of
the patient.
The laboratory may reject a cervical sample for the following reasons:
one or more of the key patient identifiers is absent
the laboratory cannot confirm the person’s identity with full certainty
  7
Topic 5: cervical screening sample requests
Specimen rejection (2)
There should be a minimum of 3 legible and correct patient demographics
(ideally including the NHS number) to identify an individual and match them
with any existing record on the pathology system.
The minimum identifying requirements are:
the person’s full name including first name and surname
the person’s date of birth
ideally the person’s NHS number
the person’s home address, as a fourth identifier
  8
Topic 5: cervical screening sample requests
Specimen rejection (3)
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The request form and vial must match each other. Provide the laboratory with
all the appropriate information to enable the test to be processed and then
reported. There should be a minimum of 3 legible and correct patient identifiers
to link a form and vial that arrive at the laboratory together.
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The sample taker must establish that a person is eligible for a test and that
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Check the vial to make sure it has not passed its expiry date. The vial must
have at least 14 days remaining. The laboratory cannot carry out high-risk
human papillomavirus (hrHPV) testing on expired vials.
  9
Topic 5: cervical screening sample requests
Specimen rejection (4)
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Trainee sample takers should use the unique PIN assigned to them at the
beginning of their training period that identifies them as a trainee.
Sample takers should take responsibility for communicating events leading
to rejection of a sample to the person concerned in an honest and sensitive
manner. The sample taker should advise the person when they can have
another sample taken.
Do not take repeat samples within 3 months of a previous test. This
allows sufficient time for the cervical epithelium to regenerate and avoids
a false result.
  10
Topic 5: cervical screening sample requests
Incidents
Sample takers should report and discuss any rejected samples with their cervical
screening mentor. This should always include any sample where the laboratory has had
to reject the test due to insufficient and conflicting information or because it was taken
inappropriately.
Sample takers should reflect on such events, make sure they are formally recorded
internally and reported as necessary according to local clinical governance policies. For
situations that fulfil the criteria of a ‘screening incident’, manage them in line with national
screening incident guidance.
www.gov.uk/government/publications/managing-safety-incidents-in-nhs-screening-
programmes
Recording, auditing and reporting errors is important to identify any problems in the local
sample taking process. This reduces the risk of potential incidents and gives an
opportunity for learning and quality improvement.
  11
Topic 5: cervical screening sample requests
Correct follow-up and management
It is the sample taker’s responsibility to make sure a person has the correct
follow-up and management as advised in the cervical screening report.
The sample taker should respond to any failsafe enquiries from the cervical
screening laboratory or colposcopy clinic and document any correspondence
or communication with the individual regarding follow-up.
  12
Topic 5: cervical screening sample requests
Guidance for the training of cervical
sample takers
End of Topic 5. Sample quality and cervical screening sample requests
  13
Topic 5: cervical screening sample requests
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Efficient and accurate cervical screening sample requests are crucial for timely and appropriate patient management. Utilizing the Open Exeter system, sample takers can access pre-populated forms to streamline the process. When deviating from Open Exeter, providing a valid explanation ensures continuity of care. Understanding sample requirements and using the recommended forms minimizes errors and delays in processing samples for cervical screening.


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  1. Guidance for the training of cervical sample takers Topic 5: cervical screening sample requests

  2. Note Use these slides in conjunction with the NHS Cervical Screening Programme publication Guidance for the training of cervical sample takers , available at: www.gov.uk/government/publications/cervical-screening-cervical-sample-taker- training 2 Topic 5: cervical screening sample requests

  3. Open Exeter Open Exeter gives access to patient data held on the National Health Application and Infrastructure Services (NHAIS) systems, which holds information relating to cervical screening. https://digital.nhs.uk/services/nhais/open-exeter The programme recommends the Open Exeter web-based application for all administration. Open Exeter references data from the national call and recall system and holds the master screening history records. This gives the cervical screening laboratory immediate access to relevant data when reporting a test in order to specify an appropriate next action. This in turn minimises the likelihood of rejection of invalid test results by the call and recall system and reduces delays in issuing results to people. 3 Topic 5: cervical screening sample requests

  4. Sample request forms (1) Sample takers should use the pre-populated HMR101 cervical cytology request forms (2009 version) available via Open Exeter. Sample takers must: know how to download the correct pre-populated HMR101 cervical cytology request form (2009 version) from the Open Exeter application be an authorised user and follow the guidelines for completion of the form and produce the preferred size for the cervical screening laboratory Failure to use Open Exeter forms may result in either delays due to the laboratory checking the full history on Open Exeter or the risk of issuing an inappropriate management recommendation by the laboratory. 4 Topic 5: cervical screening sample requests

  5. Sample request forms (2) If a sample taker uses a non-Open Exeter request form for a legitimate reason, for example, the patient is not yet registered or the Open Exeter system is unavailable, they must provide an explanation on the non-Open Exeter request form with the recent and relevant history. Where laboratory electronic requesting systems are in use, there must be mechanisms in place to provide the past screening history as it is on Open Exeter. This ensures sample takers do not take unnecessary samples and that laboratories are able to give correct patient management recommendations. 5 Topic 5: cervical screening sample requests

  6. Sample requirements The sample taker is responsible for making sure a person is eligible for cervical screening and due a test. The sample taker takes the sample in the required manner and transfers into the sample vial. The sample taker sends the form and labelled vial on the same day to the assigned cervical screening laboratory. 6 Topic 5: cervical screening sample requests

  7. Specimen rejection (1) Cervical cytology samples must satisfy the minimum requirements for processing and auditing. www.gov.uk/government/publications/cervical-screening-accepting-samples-in- laboratories The laboratory rejects erroneous samples that compromise the safety of the patient. The laboratory may reject a cervical sample for the following reasons: one or more of the key patient identifiers is absent the laboratory cannot confirm the person s identity with full certainty 7 Topic 5: cervical screening sample requests

  8. Specimen rejection (2) There should be a minimum of 3 legible and correct patient demographics (ideally including the NHS number) to identify an individual and match them with any existing record on the pathology system. The minimum identifying requirements are: the person s full name including first name and surname the person s date of birth ideally the person s NHS number the person s home address, as a fourth identifier 8 Topic 5: cervical screening sample requests

  9. Specimen rejection (3) There is major labelling discrepancy between the vial and the form The request form and vial must match each other. Provide the laboratory with all the appropriate information to enable the test to be processed and then reported. There should be a minimum of 3 legible and correct patient identifiers to link a form and vial that arrive at the laboratory together. The patient is not due a cervical sample The sample taker must establish that a person is eligible for a test and that a test is now due. The sample is received in an out-of-date or inappropriate vial Check the vial to make sure it has not passed its expiry date. The vial must have at least 14 days remaining. The laboratory cannot carry out high-risk human papillomavirus (hrHPV) testing on expired vials. 9 Topic 5: cervical screening sample requests

  10. Specimen rejection (4) The sample taker does not have a valid PIN code Trainee sample takers should use the unique PIN assigned to them at the beginning of their training period that identifies them as a trainee. Sample takers should take responsibility for communicating events leading to rejection of a sample to the person concerned in an honest and sensitive manner. The sample taker should advise the person when they can have another sample taken. Do not take repeat samples within 3 months of a previous test. This allows sufficient time for the cervical epithelium to regenerate and avoids a false result. 10 Topic 5: cervical screening sample requests

  11. Incidents Sample takers should report and discuss any rejected samples with their cervical screening mentor. This should always include any sample where the laboratory has had to reject the test due to insufficient and conflicting information or because it was taken inappropriately. Sample takers should reflect on such events, make sure they are formally recorded internally and reported as necessary according to local clinical governance policies. For situations that fulfil the criteria of a screening incident , manage them in line with national screening incident guidance. www.gov.uk/government/publications/managing-safety-incidents-in-nhs-screening- programmes Recording, auditing and reporting errors is important to identify any problems in the local sample taking process. This reduces the risk of potential incidents and gives an opportunity for learning and quality improvement. 11 Topic 5: cervical screening sample requests

  12. Correct follow-up and management It is the sample taker s responsibility to make sure a person has the correct follow-up and management as advised in the cervical screening report. The sample taker should respond to any failsafe enquiries from the cervical screening laboratory or colposcopy clinic and document any correspondence or communication with the individual regarding follow-up. 12 Topic 5: cervical screening sample requests

  13. Guidance for the training of cervical sample takers End of Topic 5. Sample quality and cervical screening sample requests 13 Topic 5: cervical screening sample requests

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