Cervical Smear & Exam

Introduces self	0	1
Confirms name & age of patient	0	1
Explains & gains consent	0	1
Asks patient if they have had any vaginal discharge, pain or itching and whether they’ve had a previous smear and their experience. Also ask if patient has previously given birth and is sexually active, informing them that these questions allow you to select an appropriately sized speculum	0	1	2
Informs patient that a chaperone will be present	0	1
Informs the patient that it is possible to lock the room to maintain privacy	0	1
Asks patient to undress behind the curtain from the waist down and lie flat on the couch covering themselves with a towel	0	1
Collect equipment (gloves, speculum, collecting pot, brush, lubricant). Check that equipment is in date	0	1
Washes hands	0	1
Expose patient and ask them to bend their knees, bringing their feet to their bottom and let their knees drop either side	0	1
Inspect the external genitalia for any discharge, scars, cysts or any other abnormalities	0	1
Ask the patient if they have any pain and inform the patient that you are about to begin the examination and that they can tell you to stop at any time	0	1
Open the speculum and check it is functional	0	1
Apply lubricant only to the sides of the speculum to avoid covering the cervix with lubricant	0	1
Insert the speculum slowly parting the lips of the labia with your non-dominant hand. Insert horizontally then turn vertically as you progress. Then when it is as far in as possible, warn the patient before gently opening the blades and bring the cervix into view. Lock the speculum in this position by tightening the screw	0	1	2
Inspect the cervix for any abnormalities including irritation or lesions	0	1
Sample the cells by introducing the tip of the brush into the cervix and turn 5 times clockwise. Remove the brush and bang the tip 10 times on the bottom of the collecting pot	0	1
Remove the speculum slowly with or without rotating it. Be careful not to clamp the cervix when closing the blades or pull any pubic hair	0	1
Allow the patient privacy and tissues to clean the area and redress	0	1
Label the bottle and dispose of all waste in the appropriate bin	0	1
Summarises appropriately with only key findings	0	1
Offers appropriate differential diagnoses if any abnormalities noted and explains these to patient	0	1
Inform the patient to expect the results by post and that their GP will call if there is any required follow up. Otherwise they will need another routine smear in 3 years. Remind them again that the purpose of the smear screening programme is to look for precancerous changes to treat before any cancer develops	0	1
Inform the patient it is normal to occasionally have a little spotting for a day or two following a smear but to report any heavy or painful discharge	0	1
Patient global score	0	1	2

Share this

Related Posts