Postal Audit Research Articles

Glass rod detectors for small field, stereotactic radiosurgery dosimetric audit

This paper demonstrates the feasibility of using glass rod detectors for quality assurance audit of radiosurgery units. Five radiosurgery units (3 Gamma Knife model C, 1 Gamma Knife model U and 1 Cyberknife) located in California participated in the study. At each center glass rod detectors were used to measure a number of dosimetric parameters including relative collimator output factor and absolute dose rate. The Gamma Knife data obtained is in excellent agreement with the commissioning data generated by the manufacturer for each unit and the Cyberknife data is in general agreement with the data published by other centers. In particular the output factor of the 4 mm Gamma Knife helmet factor, a subject of abundant debate, was measured in the range 0.863-0.872 with an accuracy of better than 1% across the four participating centers. It is hoped that this pilot study will facilitate a nationwide postal audit of stereotactic radiosurgery units.

Focusing on those in need: a symptom based outcome questionnaire for postal inwitation and audit in a primary care asthma clinic.

To focus asthma care on those patients most in need whilst providing annual audit data. An observational questionnaire study. Patients on the asthma register received a postal invitation to the asthma clinic plus a questionnaire which enquired about both symptoms and the process of care. Medical records were searched for data on non-responders. Of the 1241 people sent the invitation and questionnaire 682 (57%) returned it and 99 attended the clinic. Follow-up of responders with high morbidity resulted in a further 32 people attending. The 99 attenders had a higher morbidity than non-attenders on the criteria of a course of oral steroids in the last six months(15% v 29%)and a mean symptom score of 3 or more ( 12% v 31%). Whilst the process did focus care on those in need, and resulted in a manageable number of people attending the asthma clinic, many individuals with high morbidity or risk factors did not attend.

The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists

Recent reports have highlighted the importance of having good evidence on the safety of acupuncture. 1 2 Sound evidence on the risks associated with acupuncture is, however, scarce.3 Our primary...

Parents' understanding of a randomised double-blind controlled trial.

Recent reports in the media about the NHS inquiry at a North Staffordshire hospital have highlighted concerns about clinical trials involving children, especially about informed consent and the information given to parents. An inquiry led by Professor Griffiths has recommended that the Department of Health produce guidelines for the conduct of clinical trials (Boseley 2000, Rumbelow and Johnstone 2000). The UKCC Code of Professional Conduct (1992) requires that nurses must ‘act always in such a manner to promote and safeguard the interests and well being of patients and clients’. Polit and Hungler (1991) summarise informed consent as meaning ‘subjects have adequate information regarding the research; are capable of comprehending the information and have the power of free choice, enabling them to voluntarily consent to participate in the research or decline participation’. While actively recruiting pre-school children for a randomised controlled trial, the research team became aware that despite adhering to the consent procedure and regular contacts with parents, 14 of the 54 participants failed to complete the trial as requested. Albert and Chadwick (1992) suggest that effective communication can only take place if a message is successfully and completely transferred from one person to another. It was important that the research team (two nurses, a registrar and a consultant) were able to identify and understand any potential communication problems with the information given about the trial. A retrospective postal audit of all 54 participants was carried out to address the question of why some parents failed to complete the trial and if information given to parents should be adapted. The results of this audit will be presented in this article.

UK Audit of Childhood Growth Hormone Prescription, 1998

AIMSTo identify all young people prescribed growth hormone in the UK as of 1 October 1998 and to determine their age, sex, and the indication for therapy.METHODSCross sectional national postal...

In the light of Bournewood

Aims and MethodA postal audit of practice in the South-East Thames Region of England before and after the Bournewood judgements.ResultsThere was a trebling in the rate of admission under section of elderly incapacitated patients occurred prior to the Houseof Lords' ruling. By the time of the ruling many consultants had not changed their practice. There is now, however, no impact of the ruling upon clinical practice. The majority of consultants remain concerned about the lack of safeguards for mentally incapacitated elders at the present time.Clinical ImplicationsAlthough the Bournewood judgement was expected by some to have a permanent impact upon the management of the mentally incapacitated this has not happened. There is a need for effective and resource efficient safeguards for the mentally incapacitated to be developed.

167A multi-purpose solid phantom for postal TLD and film audit — Feasibility study

167A multi-purpose solid phantom for postal TLD and film audit — Feasibility study

Report of an audit into third molar exodontia

A postal audit of the main surgical variables in third molar exodontia under general anaesthesia was undertaken on consultants holding a National Health contract within the British Isles. This first paper presents the results. A response rate of 175 returned questionnaires from the 247 consultants was obtained (70.9%). Analysis revealed that the majority of consultants use antibiotics, mouthwashes, sutures, analgesics and postoperative review and the minority steroids and peroperative local anaesthetic, routinely in the majority of cases. Approximately half routinely use a chisel as opposed to a bur for bone removal. The consultants who gave all their patients steroids were significantly (p<0.01) more likely to possess a medical qualification than the consultants who did not.