Clinical Practice Guidelines for Nurses Undertaking ...

1 ExitMain Menu | Index Sections 1-5 | Index Sections 6-9 | Resources | Contacts | Links | References | Print | Quit iiProduced as part of PapScreen Victoria, the Victorian component of the National Cervical Screening Program. PapScreen s Communications and Recruitment Program is resourced through Commonwealth and State funding from the Victorian Department of Human by PapScreen Victoria and The Cancer Council Victoria The Cancer Council Victoria 2006 First produced in 2000. Updated 2005 Prepared by Louise MarsonFurther copies of the Guidelines on CD-ROM can be obtained by contacting PapScreen on 9635 5000 or PapScreen Victoria, The Cancer Council Victoria nor any other person associated with the preparation of these Guidelines accepts any contractual, tortious or other liability whatsoever in respect of the contents or any consequences arising from their Guidelines are made in good faith.

2 No person associated with the preparation of these Guidelines accepts legal liability or responsibility for such advice or first edition of the Clinical Practice Guidelines for Nurses Undertaking Cervical Screening in Victoria ( the Guidelines ) were developed by Family Planning Victoria in 2000 through funding from PapScreen Victoria. A number of people have contributed to updating the Guidelines : Ms Sandy Anderson, nurse Consultant for PapScreen Victoria The consultation review panel:- Ms Rosey Cummings, Acting Nursing Services Manager, Melbourne Sexual Health Centre- Ms Rochelle Hamilton, Acting Primary Care Co-ordinator/Women s Health nurse , Corio Community Health - Dr Kelsey Hegarty, Associate Professor, Director of Postgraduate Programs, Department of General Practice , The University of Melbourne- Ms Genevieve Lilley, Family Planning nurse , Wimmera Health Care Group.

3 Practice nurse and Midwife- Dr Kathy McNamee, Senior Medical Officer, Family Planning Victoria- Ms Catherine Shimmin, Women s Health nurse ; Chair of the Women s Health nurse Association of Victoria- Ms Karin Stanzel, Women s Health nurse , Yarra Valley Community Health ServiceMain Menu | Index Sections 1-5 | Index Sections 6-9 | Resources | Contacts | Links | References | Print | Quit iii- Ms Yvonne Sumner, Manager, Health Promotion and Service Co-ordination, Women s Health Program, Royal Women s Hospital- Ms Lynne Walker, Practice nurse , Family Medical Centre, Sunbury; President of the Australian Practice Nurses Association - Ms Anne Watts, Women s Health nurse , Sunraysia Community Health Centre Women s Health nurse Association of Victoria Australian Practice Nurses Guidelines provide Nurses with access to uniform high quality standards related to a broad range of Clinical Practice settings.

4 Use of these Guidelines provides high standard benchmarks which are relevant for continuous quality Guidelines are designed for use by Nurses providing cervical screening across a range of service areas. The Guidelines are based on current evidence and opinions of best Practice , and are consistent with the Family Planning Australia New South Wales Clinical Practice Guidelines (2003) and the Australian Women s Health Nurses Association Inc s Women s Health nurse Clinical Practice Guidelines , Protocols and Procedures (2003).5 Quality Assurance4 Infection Control3 Health & Safety2 Consumer rights1 IntroductionMain Menu | Index Sections 1-5 | Index Sections 6-9 | Resources | Contacts | Links | References | Print | Quit iv1.

5 INTRODUCTION The Provider .. The Role of the Women s Health nurse .. Practice Background and Boundaries of Practice .. Credentialling .. Professional Indemnity .. Organisational Philosophy .. Rights and Needs of Clients .. Health Promotion ..42. CONSUMER RIGHTS Confidentiality and Privacy .. Mandatory Reporting .. Negligence .. Duty of Care .. Anti-discrimination .. Informed Consent .. Principles .. Menhennitt Ruling ..83. HEALTH AND SAFETY Occupational Health and Safety Regulations .. Injury in the Health Care Setting .. Equal Opportunity, Discrimination and Harassment ..94. INFECTION CONTROL Principles.

6 Standard Blood and Body Fluid Precautions .. Strategies for Infection Control .. Quality Management practices .. Effective Work practices and Procedures .. Design and Maintenance of Health Care Setting .. Hand Washing .. Personal Protective Equipment .. Handling and Disposal of Sharps .. Disposal of Clinical Waste .. Single Use Equipment .. Reprocessing of Reusable Instruments and Equipment .. Surfaces .. Manual Cleaning of Instruments .. Sterilising Instruments .. Correct Loading .. Monitoring the Sterilisation Process .. Blood and Body Fluid Spills Management ..16 SECTIONS 1 5 PRINCIPLES UNDERPINNING Clinical Practice FOR Nurses Undertaking CERVICAL SCREENING IN VICTORIA5 Quality Assurance4 Infection Control3 Health & Safety2 Consumer rights1 IntroductionMain Menu | Index Sections 1-5 | Index Sections 6-9 | Resources | Contacts | Links | References | Print | Quit Spot Cleaning.

7 Spills .. Collection of Specimens .. Linen .. Immunisation Guidelines for Health Care Professionals .. Vaccination Program .. Refrigerators .. Needle Stick Injury and Other Blood or Body Fluid Incidents .. Immediate Management ..185. QUALITY ASSURANCE Accountability of the Women s Health nurse .. Continuing Education .. Client Records and Audits .. Referral .. Disposal of Documents .. Storage of Pharmaceuticals .. Equipment Maintenance .. Security .. Smoking Policy ..239 Counselling8 General women s health issues7 Contraception6 Preventative health checksMain Menu | Index Sections 1-5 | Index Sections 6-9 | Resources | Contacts | Links | References | Print | Quit vi6.

8 PREVENTATIVE HEALTH CHECKS Guidelines for General Consultation by the Women s Health nurse .. Pap Test .. Pelvic Examination/Bi-manual Examination .. Preceptorship .. Preceptorship Program .. Contractual Arrangement .. Professional Support .. Breast Health and Screening .. Clinical Breast Examination (CBE) .. Breast Awareness .. Screening for Sexually Transmissible Infections (STIs) for Asymptomatic Women ..337. CONTRACEPTION Methods of Contraception .. Combined Oral Pill (COP) .. Progestogen-only pill (POP) .. Emergency Contraception .. Depo Provera .. Implanon .. Intrauterine Devices (IUD) .. Sterilisation (Female/Male).

9 Barriers (Diaphragm/Cap) .. Barriers (Condoms) .. Natural Family Planning Consultations .. Lactational Amenorrhoea ..548. GENERAL WOMEN S HEALTH ISSUES Other Women s Health Issues .. Pre-Conceptual Care .. Sub-Fertile Couple .. Continence (Bladder or Bowel Incontinence Issues) .. Menopause .. Vaginal Health .. Common Gynaecological Conditions ..589. COUNSELLING General Counselling Consultations .. Pregnancy Testing for Planned and Unplanned Pregnancy .. Pregnancy Counselling for Unplanned Pregnancy .. Continuing with Pregnancy .. Considering Adoption .. Considering Termination ..60 SECTIONS 6 9 Clinical Practice Guidelines FOR Nurses Undertaking CERVICAL SCREENINGR eferencesLinksContactsResourcesMain Menu | Index Sections 1-5 | Index Sections 6-9 | Resources | Contacts | Links | References | Print | Quit viiRESOURCE A 62 The National Policy for the Prevention of Cervical Cancer.

10 Policy OverviewRESOURCE B 62 Guidelines for the Management of Asymptomatic Women with Screen Detected AbnormalitiesRESOURCE C 63 Sexual History-taking ProformaRESOURCE D 63 Procedure for Cervical Screening Recall SystemRESOURCE E 66 Client Letters for Notification of ResultsRESOURCE F 67 Procedure for a Pap TestRESOURCE G 69 How to Take a Better Pap SmearRESOURCE H 69 The Speculum ExaminationRESOURCE I 70 Taking a Pap SmearRESOURCE J 70 Procedure for Taking a Pap Smear UsingRESOURCE K 71 Procedure for Bi-manual ExaminationRESOURCE L 72 Procedure for Breast ExaminationRESOURCE M 74 Clinical Breast ProformaRESOURCE N 74 Women s Health nurse ProtocolRESOURCE O 76 Women s Health nurse Protocol for Management of the Client Who Presents with a Vaginal DischargeRESOURCE P 77 Hepatitis B Vaccination Authorisation FormRESOURCE Q 77 Emergency Contraception Authorisation FormAPPENDICESR eferencesLinksContactsResourcesMain Menu | Index Sections 1-5 | Index Sections 6-9 | Resources | Contacts | Links | References | Print | Quit viiiRESOURCE R 78 Women s Health nurse Protocol for the Management of the Client Who Presents Requesting Emergency ContraceptionRESOURCE S 79 Depo Provera Authorisation FormRESOURCE T 79 Procedure for Diaphragm FittingCONTACTS 80 LINKS 82