Improving the uptake of cervical screening in pregnant and recently postnatal women: a quality improvement project

BMJ Open Quality

article

Sarah Louise Coleridge¹  Alison Wiggans²  Ellen Nelissen³  Rob Bethune⁴  Richard Blackwell⁴  Andrew Bryant⁶  Jo Morrison⁷ 

[1] Obstetrics and Gynaecology , Nottingham University Hospitals NHS Trust;Gynaecological Oncology , Gloucestershire Hospitals NHS Foundation Trust;Gynaecological Oncology , Royal Marsden NHS Foundation Trust;South West Academic Health Science Network;Department of Surgery , Royal Devon and Exeter NHS Foundation Trust;Institute of Health and Society , Newcastle University;Gynaecological Oncology , Somerset NHS Foundation Trust

关键词: healthcare quality improvement;    obstetrics and gynecology;    patient education;    statistical process control;    health promotion;   

DOI  :  10.1136/bmjoq-2021-001709

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Background In 2018, cervical screening uptake was at its lowest level since screening began, particularly in those aged 25–35, coinciding with the peak incidence of cervical cancer and average age at first delivery.Problem Retrospective baseline data of pregnant women found 47.3% (n=123/260) were overdue for screening by delivery, of whom 74% (n=91/123) remained overdue by 6 months postnatal.Methods We undertook a quality improvement project from April 2018 to April 2019 to improve cervical screening uptake in pregnant and postnatal women. We mapped out the screening process and canvassed stakeholders. The main theme was inconsistency of advice received by women. From February 2018 to May 2020, we undertook a prospective audit of 10 women per week who gave birth in our maternity department, recording screening status at delivery and 6 months postnatal.Interventions included introducing evidence-based guidelines about cervical screening in pregnancy and the postnatal period, flow charts for maternity staff, multiprofessional teaching for all maternity staff and information dissemination to women (via the HANDiApp platform, a social media campaign and adapting results letters following colposcopy, highlighting dates when screening would be due). Primary care opening hours were extended for screening and women received a letter from their midwives, if they required cervical screening in pregnancy.Results Locally, the percentage of women overdue for cervical screening by 6 months postnatal improved by 8.0% during this project, compared with a 1.6% change in national screening rates in women aged 25–49.Conclusions We increased the percentage of local pregnant and postnatal women attending cervical screening by introduction of a package of information, targeted education and widening access to screening appointments.

【 授权许可】

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