Page 45 - Q BULLETIN, Ministry of Health Malaysia, VOLUME 1, NO. 31 (SUPPLEMENT 1), JAN-DEC 2022

Q Bulletin, Volume 1, No. 31 (Supplement 1), Jan - Dec 2022
th
11 National QA Convention, 4 – 6 October 2022
PP-07

Increasing the Percentage of Pap Smear Screening among Women Aged 30-65 Years Old
in Tanah Puteh Health Clinic (KKTP)

Peter J, Irene WTY, Mariam Y, Hamibah NB, Habsah AHB, Dayang NAAM, Majang S, Kimbing RR, Saila
S, Patrick A
Tanah Puteh Health Clinic (KKTP), Sarawak

SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:
Pap smear (PS) screening can detect the earliest signs of cervical cancer. However, from 2017-2021, KKTP
failed to achieve the PS screening target for women aged 30–65.

KEY MEASURES FOR IMPROVEMENT:
The percentage of women aged 30-65 who performed PS screening from the total eligible women attending
KKTP in 2022 with a standard of 40%.

PROCESS OF GATHERING INFORMATION:
Cross-sectional studies were done to determine the percentage of screening done from 2017 to 2021, level of
knowledge, attitude and practice (KAP) on PS among 70 women aged 30-65 who visited KKTP and 81 health
care providers (HCP) who were involved in PS service. The survey was done using a validated questionnaire.
A list of staff with credentialing and privileging (C&P) to perform PS and e-Masa analysis to evaluate waiting
time for the procedure was also determined.

ANALYSIS AND INTERPRETATION:
Pre-remedial data showed that the percentage of PS screening was <17% since 2017. The mean score for KAP
on PS among patients was 65.57%, 89.86% and 95%. Average KAP scoring among HCP showed that attitude
and practice scored lower than knowledge. The mean waiting time was 105 minutes. Only 37% of nurses have
C&P for PS.

STRATEGIES FOR CHANGE:
Strategies include monthly campaigns using pamphlets, posters and social media, implementing score cards as
a reminder system for HCP to promote PS, creating a fast lane for patients to access the dedicated team for PS
and having an internal C&P system.

EFFECT OF CHANGE:
The percentage of screening during the study period increased from 9.56% to 51.22%. The mean scores for
patients’ KAP were improved to 81.29%, 92.71% and 97.57% and from 78.52%, 63.09%, 47.6% to 90.61%,
71.6%, 53.36% for HCP. Mean waiting time was reduced to 17 minutes.

THE NEXT STEP:
We aim to replicate the strategies in other clinics, create a module for internal C&P and empower the use of
score cards as a reminder system for HCP.

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