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AUDIOLOGY UNIT |
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Last updated 6th September 2000 |
|
AUDIOLOGY UNIT |
|
Last updated 6th September 2000 |
INDEX
DESCRIPTION: A test that both informs the user of the integrity of the cochlea and the conductive pathway to the cochlea. The technique allows a means to exclude significant hearing impairment in individuals.
LOCATION: The test can take place in a sound proofed or sound treated room within the Audiology Unit at YGC.
PATIENT CATEGORY: The response to click evoked oto-acoustic emissions (OAEs) will be carried out on any patients as deemed necessary from neo-natal to older patient or any subject indicated either as a consequence of organic disease, non-organic hearing loss or as referred. Referrals will be received from ENT medical staff or generated within the normal departmental work.
PROTOCOLS: HUMAN RESOURCES: OAEs can be performed by appropriately qualified and experienced MTO staff and Audiological Scientist. However, younger age groups i.e. pre-school will require a senior MTO or Audiological Scientist.
APPOINTMENT TIME: 90% of patients requiring click evoked OAEs will be seen within four weeks of referral.
WAITING TIME: 90% of patients will be expected to wait no longer than 20 minutes to receive the test with an explanation given for any delays.
TEST DURATION: OAEs ca. 20 minutes
SET-UP EQUIPMENT: ILO 88 equipment
Appropriate ear probe
Appropriate ear probe tip
SET-UP ENVIRONMENT: Adequately furnished quiet room with good lighting. With patient sat in front of the ILO 88 equipment with the probe wires attached and stabilized on the patient to avoid excessive relative movement/noise between probe and ear that can mitigate the results.
PATIENT MANAGEMENT:
(1) BRIEFING: The patient has to be fully informed of the procedure and what will be experienced during the investigation.
(2) INVOLVEMENT OF OTHERS: Children under the age of sixteen should ideally be accompanied by an adult. Patients in care should have an escort from their place of residence.
(3) PATIENTS INSTRUCTIONS: The patient (were possible) will be requested to sit as quietly and still as possible throughout the investigation which should take no more than two minutes to perform. During this time a probe will be inserted into the ear canal and may need relocating depending on the coupling to the ear canal.
(4) PATIENT DEBRIEFING: A clear explanation of the test results will be given to the patient and his or her escort. Provided that this information is relevant and that it is not to be discussed with the medical referrer.
PRODUCT METHOD:
(1) Equipment and attachments are prepared prior to attaching to patient.
(2) The patient should be fully informed of the test procedure and or any concern alleviated as far as possible.
(3) A visual examination of the patients ear is made using an otoscope, however, middle ear analysis will be necessary prior to investigation in order to exclude any middle ear disfunction that may be a contra indication to testing or help in the interpretation of the results.
(4) Optimal recording should be obtained from the co-operation of the patient and maintaining their quiescence and lack of movement throughout the investigation.
(5) Probe placement and patency in the ear is critical and problems of this nature should be identified from the equipment monitoring software. Initial checks should be carried out to monitor presence of the stimulus, Reference Stimulus presence and linearity and use of the "Check fit" facility.
(6) All the necessary findings should be documented in a suitable format.
(7) Results should then be accurately interpreted and the need for further tests established.
RESULTS: The click evoked OAEs will be presented using the ILO 88 hard graphics print out and a written report provided to the referring clinician drawing attention to such matters as the evoked emission spectrum ("Response FFT") in term of presence above the "noise floor" and the frequency range over which the response was recorded along with the percentile OAE confidence of the results.
REPORTS: An individual test report will be produced for each patent comprising summary of results and conclusions. This may be incorporated into a larger report of other audiological investigations.
STANDARDS NATIONAL: None.
STANDARDS LOCAL ADDITIONAL POINTS:
All staff and procedures must conform to the Trusts General Policies and Procedures. These can be found from the Trust Information Server on the local IntrAnet at http://www.cd-tr.wales.nhs.uk/polproc/2000_launch/welcome.htm
OAE equipment should be calibrated to the local specifications of the North Wales Medical Physics Department in accordance with the manufactures specifications.
AUDIT OF QUALITY INTERNAL: Once in a six month period the length of time the patients wait for procedure will be monitored and the results recorded and made available for external audit.
An Audiological Scientist, grade B or above with CAC qualification should monitor a sample of the test carried out to ensure correct test practises and protocols are being observed by equipment users. Monitoring of procedures should be according to the defined local protocols these are to be logged and available for external audit.
AUDIT OF QUALITY EXTERNAL:
COST:
VOLUME: