CALD identification questions - APNA

Nurses enhancing their quality of
practice in cervical screening
Sandy Anderson
Nurse Consultant
PapScreen Victoria
Kirsten Hausknecht
Community Health Professionals Coordinator
PapScreen Victoria

Today, we will be covering the following:
• Overview of PapScreen Victoria and the Identification Project
• How the project lead to the Statistical Record worksheet
• Using the worksheet and the recent changes to practice
nurse funding to your advantage and enhance your clinical
practice

How does PapScreen Victoria operate
• Based within Cancer Council Victoria
• Run public awareness campaigns
• Work with health professionals to ensure Pap tests are as
accessible and stress-free as possible for women
• Find out what women think about Pap tests, and use this
research to inform our work
• Aim to reach unscreened and underscreened women:
– Older women
– Koori women
– Lesbians
– Women with disabilities
– Women from diverse cultures
– Women from low socio economic status

Victoria’s Cancer Action Plan 2008 - 2011
One target was the need to develop systems to measure
baseline identification data for Aboriginal and Torres
Strait Islander (ATSI) and Culturally and Linguistically
Diverse (CALD) groups in cervical screening.
A partnership was formed in 2008 including:
• Victorian Department of Health
• Victorian Aboriginal Community Controlled Health
Organisation
• PapScreen Victoria
• Victorian Cytology Service
• Victorian Cervical Cytology Registry

Recording of ATSI identification data pilot
• Phase 1 of the project commenced with Victorian
credentialled cervical screening nurses recording
ATSI identification data in September 2008
• 287 nurses who use Victorian Cytology Service
(VCS) participated in the pilot
• Cultural awareness training was provided regarding
how to ask the question
• ATSI identification question added to the VCS
pathology request forms
• 48% of the nurses recorded ATSI data during the pilot

ATSI identification question
Is the patient of Aboriginal or Torres
Strait Islander origin
□
□
□
□
Aboriginal
Torres Strait Islander
Aboriginal and Torres Strait Islander
Not Aboriginal or Torres Strait Islander

CALD identification questions
In which country was the patient born
………………………..
Does the patient speak a language other than English at
home (If more than one indicated the one spoken most
often.
□ No, English only □ Yes, other
…………………………………………………………………
Please specify
…………………………………………………………………

Collection of ATSI identification data increased
• The pilot evaluation identified collection rates
increased with additional education and training
• PapScreen Victoria included training information in all
professional development workshops held in 2010
• The impact of the training increased the average
ATSI collection rate for nurses to 67.5% in 2010
• ATSI and Culturally and Linguistically Diverse
(CALD) identification data collection was included in
the recredentialling process from 2012

Percentage of ATSI identification data collected
48% 49%
67%
87%
Year
Data provided
by VCS 2012

Country of birth and language spoken at home
identification data collected in 2011
Data provided
by VCS 2012

Nurses who use private pathology services
• All nurses are required to collect ATSI and CALD
identification data, including nurses who practice under a
doctors name using a private pathology company
• Previously nurses mainly kept a paper record of their
cervical screening data to use when they recredentialled
every three years
• PapScreen Victoria developed an electronic worksheet.
The worksheet enables reporting facilities to assist all
nurses to be able to report on their own general practice
population and cervical screening reach

PSV worksheet
reporting features:
general summary

PSV worksheet
reporting features:
CALD summary

Changing role of the general practice nurse
Operating roles of the practice nurse –
1. Patient carer
2. Organiser
3. Quality controller
4. Problem solver
5. Educator
6. Agent of connectivity
C Philips et al. 2009 “Enhancing Care, improving quality: the six roles of the general practice nurse”
A study in 2011 found only 6% of nurse activities
generated a fee
C Pearce et al. 2011 “Following the funding trail: Financing, nurses and teamwork in Australian general practice”

Overview of the Practice Nurse Incentive
Program
• PNIP introduced 1 January 2012
• Supports role of Registered & Enrolled nurses, and
Aboriginal Health Workers in general practice
• Allocated according to nursing hours
• Allows the opportunity for nurses to further develop
their role within primary health care

Advancing the role of the practice nurse
• The PNIP is creating an opportunity for nurses to
promote advanced nursing skills within the general
practice team
• Opportune time to commence specialised nurse
clinics such as Women’s Health / Pap clinics
• Enables specialised care which targets your specific
client population

Why start a Women’s Health / Pap clinic
• Nurses are more likely to take a Pap test from
women who are underscreened (over 2 years) – 66%
compared with 57.9% for other providers
• Nurses collect 36.8% of all Pap tests from women
aged 50 – 69 years, compared to 30.1% from other
health providers
• Pap tests conducted by nurses record a higher
technically satisfactory result
• Nurse cervical screening providers have been vital in
the Identification Project

Evaluating your practice
Evaluating your practice and participating in quality
improvement equates to Continuing Professional
Development hours.
Examples:
• Satisfaction survey
• Clinical Audit tool
• Worksheet
• Credentialling

Building your practice
By understanding the demographics of your practice you
are able to advocate for your practice with:
• General practitioners in your practice
• Practice managers
• Practice meetings
• Medicare locals
• Accreditation body
• Media – report your practice initiatives
• Colleagues
• Networking

Contact details
Sandy Anderson
Nurse Consultant
0407 190 207
sandya@ncable.net.au
Kirsten Hausknecht
Community Health Professionals Coordinator
03 9635 5403
kirsten.hausknecht@cancervic.org.au

www.papscreen.org.au