Good practice zone
The following examples of good clinical practice are just a selection of comments from the Quality Assurance teams that visited Audiology departments as part of the Newborn Hearing Screening Programme Quality Assurance programme 2006-07.
The comments provide an insight into what is happening in other departments and are included to:
- offer ideas which you may like to introduce into your own department
- encourage quality improvement within your service
- appreciate the quality of service you are already providing to deaf children and their families
If you wish to follow up any of these ideas by contacting the department with the Good Practice directly, please contact
Amy.Mclauchlan@manchester.ac.uk
Wax removal
- A nurse is available at the Impression taking sessions to remove excessive wax
- The department is able to arrange repeat impressions promptly, with immediate access to ENT acute clinic for wax removal / examination if needed
- One audiological scientist and the paediatrician are trained to remove earwax when needed for impression taking
- Audiologists are trained to remove excess wax by syringing prior to taking impressions in Community Audiology
Taking ear impressions
- A teacher of the deaf is trained to take ear mould impressions so can take impressions at the Acorn preschool group
- Training in impression taking is offered to all parent/carer(s) and has been undertaken by the Parent Support Coordinator which means that provision of new ear moulds is very swift
- Open access clinics for earmould impressions and hearing aid repairs 3 times per week, including evening clinic
- Young babies having earmould impressions taken are now booked in for their next set of impressions two weeks later, to facilitate consistent provision of good-fitting moulds
Multidisciplinary working
- Monthly meetings of the multi-disciplinary team are held to discuss the progress of the aided children under 3 years old
- There is good evidence of joint working, a regular multidisciplinary clinic is held where babies and their families can meet with all the relevant professionals involved with their care
Hearing aids
- Comprehensive local information pack given to parents at hearing aid fitting
- All departments fit children with appropriate, good-quality digital hearing aids in a choice of colours, and real ear measures are a routine part of the fitting procedure
- A letter is sent to parents following hearing aid fitting summarising the results in non technical terms and the management decisions to date
- Monthly downloading of hearing aid info onto laptop of Northumberland ToD, who carries spare aids and is therefore able to issue spares promptly to parents when needed
- At the hearing aid fitting appointment the ToD is invited and families are given an excellent information pack, along with a flow chart outlining what review and assessment appointments can be expected throughout childhood
- Audiology fit children with appropriate, good-quality digital hearing aids including mini power aids
Networking/audit
- The South West Quality Assurance group which involves Team leaders and Audiology departments across 5 neighbouring NHSP sites meets on a regular basis to discuss various issues associated with NHSP programme including case studies
- The Team Leader monitors the programme carefully producing local annual reports and audits which demonstrated a good overview of the aided children and the service provided
- Staff are keen to examine their practice and address any areas of concern or gaps, e.g. ear mould turn around
- The Audiologist is mentored by a colleague from a nearby site enabling peer review, advice and discussion, to compensate for the small ‘critical mass’ of cases being diagnosed
- This site has a low birth rate with a consequent small number of babies referred for audiological assessment. In recognition of this and to maintain competency, two senior audiologists work together so they are able to prompt each other and review traces. Further advice on interpreting traces is sought from a clinical scientist from a neighbouring site as required