The Quality of Pap Test Specimens Collected by Nurses in a Breast and Cervical Cancer Screening Clinic

Background: It is possible that nurses can help close the gap between the Healthy People 2000 clinical preventive services goals and current cancer screening rates by collecting Pap test specimens in clinical practices. The 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 January 1, 1996 and July 31, 1996. Pap tests collected by the nurses at Rosebud Hospital (N = 404) were compared to the Pap tests collected by other providers at the Rosebud Hospital (N = 118) and the Pap tests collected by providers from all other sites (N = 22,696). Setting: The Indian Health Service Hospital, Rosebud, South Dakota. Subjects: Eight nurses who had been trained to collect Pap test specimens. Main Outcome Measures: The proportion of Pap test specimens that were wholly satisfactory and the proportion of Pap test specimens collected from nonpregnant patients that lacked endocervical cells. Results: The proportion of 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 providers, and 81.7% (95% CI = 81.2–82.2) for non-Rosebud providers. The proportion of specimens that lacked endocervical cells and were from nonpregnant 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 non-Rosebud providers (95% CI = 7.6–8.2). Conclusions: After one week of training, nurses can collect Pap test specimens that are of the same quality 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 can contribute to the Healthy People 2000 goals by collecting Pap test specimens.