An Audit of Asymptomatic Screening by Health Care Assistants in all Contraception and Sexual Health Services in Haringey, North London.
ESC Congress Library. Munro H. May 28, 2014; 50516; A-101
Dr. Helen Munro
Dr. Helen Munro
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Health Care Assistants are a valuable part of the team at Haringey, North London Contraception and Sexual Health (CASH) Services. They have been undergoing training in taking asymptomatic patient histories. It is felt that this will benefit the service, patients and staff in several ways
• Reduce the time that asymptomatic patients have to wait to be seen
• Increase the number of asymptomatic patients the service is able to help
• Reduce the burden on doctors and nurses who can deal with more complex cases
• The HCA develops new clinical skills

The primary objective was to audit asymptomatic consultations carried out by the Health Care Assistants (HCA) against twelve criteria drawn from the British Association for Sexual Health and HIV (BASHH) 2013 UK national guidelines, for consultations requiring sexual history taking

Data was collected retrospectively from electronic patient records (EPR) from June 2012 to December 2012. All \"\"new\"\" or \"\"rebook\"\" patients seen by the HCAs were included. As per BASHH recommendations 40 patients were selected; with equal number of male and female patients and weighted equally for each HCA. Data was analysed using excel spreadsheet

A total number of 538 asymptomatic screens were carried out by 4 HCAs over four clinical sites in the 6 month period. 192 were male and 346 were female.
The 100 % standard was met in seven of the twelve criteria; including offering a urine naats for male patients and low vaginal swab in females, and a blood test for HIV and STS. However, there was incomplete recording of type of sex, previous sexual partner, menstrual and cytology history, and HIV and Hepatitis risk. BASHH guidelines recommend additional questions (such as hepatitis risk) which our HCAs do not currently ask.

Overall the HCAs are seeing a large number of asymptomatic patients and appropriately assessing them in the majority of cases. As a result of the audit we have
modified our templates to include the additional fields including hepatitis risk assessment and reviewed the role and training development plan for the HCAs.

• Each HCA will now be assigned a senior nurse who will meet monthly with them to individually review specific cases and EPR documentation.
• They will have the opportunity to shadow senior nurses, doctors and Health Advisors.
• They will be encouraged to keep a reflective diary of their clinical experiences as part of their annual appraisal.
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