THE QUALITY OF PAP TEST SPECIMENS COLLECTED BY NURSES IN A BREAST ANDCERVICAL-CANCER SCREENING CLINIC

It is possible that nurses can help close the gap between the Healthy People 2000 clinical preventive services goals and current cancer scre ening rates by collecting Pap test specimens in clinical practices. Th e purpose of this analysis was to determine whether nurses can collect high-quality Pap tests. Design: Retrospective cohort analysis of all Pap tests submitted to a commercial pathology laboratory: between Janu ary, 1996 and July 31, 1996. Pap tests collected by the nurses at Rose bud Hospital (N = 404) were compared to the Pap tests collected by oth er-providers at the Rosebud Hospital (N = 118) and the Pap tests colle cted by providers from all other sites (N = 22,696). Setting: The Indi an Health Service Hospital, Rosebud, South Dakota. Subjects: Eight nur ses who had been trained to collect Pap test specimens. Main Outcome M easures: The proportion of Pap test specimens that were wholly satisfa ctory and the proportion of Pap test specimens collected from nonpregn ant patients that lacked endocervical cells. Results: The proportion o f specimens that were wholly satisfactory was 79.8% (95% CI = 75.9-83. 7) for the nurses, (65.3% (95% CI = 56.7-73.9) for other Rosebud provi ders, and 81.7% (95% CI = 81.2-82.2) for non-Rosebud providers. The pr oportion of specimens that lacked endocervical cells and were from non pregnant patients was 6.4% (95% CI = 4.0-8.8) for Rosebud nurses, 8.5% for other Rosebud providers (95% CI = 3.5-13.5), and 7.9% for nan-Ros ebud providers (95% CI = 7.6-8.2). Conclusions: After one week of trai ning, nurses can collect Pap test specimens that are of the same quali ty as the specimens collected by physicians, nurse practitioners, and physician assistants. The widespread availability of female nurses and the high quality of their work suggest that they call contribute to t ile Wealthy People 2000 goals by collecting Pap test specimens. (C) 19 98 American Journal of Preventive Medicine.