NNCTR / Phase World Wide

Transcription

1 REPORT ON COLPOSCOPY PROGRAM 2011 IN UNITED KINGDOM Shrewsbury Royal Hospital Princes Royal Hospital Organized / Sponsored by NNCTR / Phase World Wide By: Mamata Shrestha NNCTR/INCTR Nepal

2 Acknowledgement These words are dedicated to all those personality who helped me with their kind support & care during the one month colposcopy training program held in Shrewsbury Royal Hospital, London. I want to give my special thanks to: - Resource Persons: Dr. Jane Panikkar Sis. Sherryl Goodall Dr. Jill Blackmore Sis. Marilyn Reah Sis. Tina Wood Prof. Malkan Dr. Martyn Underwood Sis. Sarah - External Examiners: Dr. David Fenton Dr. Esthor Moss Dr. Garda for providing and guiding the colposcopy training program, - Phase World Wide and BSCCP for funding the training program, - NNCTR/INCTR Nepal for selecting me for the training. - Princess Royal Hospital for providing accommodation. and my heart full thanks to Dr. Jane Panilkkar, Dr. Jill Blackmore, Sis. Sherryl, Sis Marilyn & Dr. Bob for making the stay so memorable, entertaining and for showing us all those beautiful and memorable places. I am glad to be the first colposcopic nurse of Nepal. Thanks of everyone. 1

3 Special Thanks to: - Phase World Wide - BSCCP - NNCTR / INCTR Nepal & All Doctors, Nurses from: - Shrewsbury Royal Hospital - Princes Royal Hospital, United Kingdom 2

4 Venue: The Shrewsbury and Telford Hospital NHS (United Kingdom) Time Duration: 18 th May to 17 th June 2011 Trainees: 1) Mamata Shrestha 2) Sita Pariyar The aim of the training program: To assist with cervical screening programs in order to reduce the burden of cervical cancer in Nepal. Improve core knowledge. Development clinical skills. Develop personal and professional attributes. Enable competency in colposcopy nurses and diagnostic colposcopy. Contents of Training: Occupational Health check up. Infection control practices. Observation of clinical set-up. Asepsis and trolley set-up. Knowledge of equipment. IT session, Library literature search. Theatre/hand washing/scrub techniques. Pelvic examination. Cervical sampling, smear taking. The Colposcopy examination/technique. Final diagnosis VIA/VILI biopsy and other diagnostics. Observation in Cytology and Histology Lab. Attendance statutory safety update for patient handlers. (CPR Moving and handling) Observation of Laparoscopy, Hysteroscopy, Ovarian cyst removal. Observation and assist in once LLETZ and Cold Coagulations. Observation of Breast examination and Biopsy taking. Observation of Gynae OPD Ward. Case management under direct supervision. Observation in Urodynamics ward. Attend class room teaching clinical skills lab. Attend Dept audit meeting. Observation in Day Surgery Unit. Attend pressure sore workshop. Attend Gynae onc MDT meeting. Observation Administration Unit Attend Cloposcopy Exam 3

5 Achievements of Training: Aware of infection control in the clinic and can perform procedures without cross-contamination. Able to set-up clinic. Able to set-up Trolley. Learned about all necessary equipments. Able to do Pelvic examination. Able to do Colpscopy examination. Learned about Cytology and histology Labs. Learned about Cardiac pulmonary respiration methods. Able to see SCJ, TZ. Able to Find VIA, VILI positive and negative. Able to take biopsy. Learned about HPV infection, Metaplasia, dyskaryosis, CIN, Invasive cancer, and abnormal cervix. Learned about VIA, VILI and Liquid base cytology Screening methods. Learned about Administrative/Documentation methods. Learned about Urodynamics procedures. Learned about Laparoscopy and Hysteroscopy. Learned about the importance of MDT Meetings. Learned about Pressure Sore Wounds. Learned about the advantages and disadvantages of VIA, VILI screening. Learned about Cryotherapy, Cold coagulation, LLETZ, Knife cone biopsy, Hysterectomy and Trachelectomy methods, and their advantage and disadvantages. Teaching Methods: Observation and Lecture methods. Practical methods. Workshops. Resource Persons: Dr. Jane Panikkar Sis. Sherryl Goodall Dr. Jill Blackmore Sis. Marilyn Reah Sis. Tina Wood Prof. Malkan Dr. Martyn Underwood Sis. Sarah External Examiners: Dr. David Fenton Dr. Esthor Moss Dr. Garda 4

6 Future Plan: If necessary instruments equipment are available, it is possible to examine the patient by Colposcope Machine. If there is management of proper instruments/environment, colposcopy clinic can be set-up in the NNCTR office aslo. Improve proper documentation. Improve quality and cross contamination control. To teach other volunteer nurses, what I have learnt. Equipments / Materials used in Training: Colposcope Machine Gynae bed Speculums Sponge holder Endo cervical speculum Biopsy Forceps Vaginal side wall retractor Cervical polyp forceps Smear / Endo cervical brush Wound care pack (Guzes, Cottons, Bowel, kidney tray) Gloves Xylokin Jelly Trolley Mensal solution/silver nitrate Applicators Legals iodine, acitic acid Bottle with formalin 5

7 Daily Activities: Date AM PM Evening 18 th May 2011 JP to collect Heathrow SAG home SAG home 19 th May 2011 Tina Wood Office 10am SAG check Rest 20 th May 2011 PRH stat Training arranged with Jane hart 21 st May 2011 SAG transfer to PRH accommodation 22 nd May 2011 SAG to arrange 23 rd May 2011 Colp clinic RSH JP/SAG Colp clinic RSH JP/SAG 24 th May 2011 Histo lb RSH Prof Malcolm Library SECC IT training Jason Curtis 25 th May 2011 Colp clinic PRH JP Class room teaching with med stu RSH clinical skills lab JP 26 th May 2011 Main Treater SH So Dept audit meeting RSH 27 th May 2011 PRH colp clinic 1 as nurse PRH colp clinic 1 as nurs Free 28 th May 2011 JP to arrange 29 th May 2011 JP to arrange 30 th May 2011 Bank holiday 31 st May 2011 AT perineal clinic RSH JP DSU RSH 1 st June 2011 JP GOPD RSH Urodynamics RSH SAG 2 nd June 2011 JP DSU RSH Pressure sore workship RSH Jill Blaskmore Dinner 3 rd June th June 2011 Free PRH colp clinic 1 as nurse RSH colp clinic 1 as nurse 6 Gynae Onc MDT

8 Date AM PM Evening 5 th June 2011 free 6 th June 2011 Clop clinic RSH JP/SAG Clop clinic RSH JP/SAG 7 th June 2011 Library Breast Screening 8 th June 2011 PRH colp clinic JP Cytology lab 9 th June 2011 Administration unit Colp clinic PRH 10 th June 2011 PRH colp clinic Colp MDT RSH 11 th June 2011 Revision Revision 12 th June 2011 Colp exam RSH JP lunch/ PHASE meeting 13 th June 2011 Colp clinic RSH JP/SAG Colp clinic RSH JP/SAG 14 th June 2011 Free JP DSU RSH 15 th June 2011 JP GOPD RSH 16 th June 2011 Return 17 th June 2011 Return Classroom teaching with med stu RSH clinical skills lab JP MR to arrange social activities 7

9 Recommendations: During training there should be practical along with theory. The trainee should have information about the facilities. They should be provided by the organization before the training program. It would be easier for the training if the trainees are provided with the guidelines. For example, a list of topics that will be covered. More information would be useful regarding living, arrangements, facilities for food, the weather and appropriate wear clothing. Submitted to: Submitted by: NNCTR/INCTR Nepal Mamata Shrestha O-O-O 8

10 Breast Screening Clinic Breast Screening Bed Well equipped hand washing basin Breast Screening Bed Counseling room 9

11 Training activities photos Trolley setup Wear plastic gown Putting on gloves Observe counseling Mamata getting familiar with Colposcope Machine Sita getting familiar with Colposcope Machine 10

12 Colposcopy Clinic Equipment Trolley Well equipped hand washing basin Colposcopy Room Gyne Bed with vedio screening Screening Set 11

13 Certificate Distribution Certificate Distribution With Prof. Malkan Certificate distribution from Dr. Jane Panikkar News Colposcopy training news on daily newspaper, London 12