WRITTEN NOTES: A PRACTICAL SOLUTION TO REDUCE PROBLEMS ARISE DURING HEARING TEST THAT REQUIRE SEDATION

Abstract

This study evaluates the success of written note containing pre-information given to patient’s caretakers prior to hearing test that requires sedation in ORL Department, Penang General Hospital. Initial findings showed about half of the patient scheduled for objective hearing test were unable to be sedated or fully completed the test on appointment day. The written notes have been introduced as a remedial measure to improve the situation. Written note is a guideline for parents that contain information on pre-test preparation. This note is attached to the patient appointment card. The objective of this written note is to reduce the number of follow up, shorten the duration of testing time/response time, and minimize the usage of sedative drug. Initial study has been conducted on 23 patients from April to July 2014 (before implementation of written notes). Information on time taken from sedation to time completed test, drug usage, number of follow up and the reasons for incomplete testing are recorded and analyzed accordingly.  All pediatric patient from 6 months to 7 years old, who attended for objective hearing test are included in this study with exception to those who are sick or not fitted for sedation. The second cycle of study has been conducted from January to May 2015 (after implementation of written notes) which involved 44 subjects that adhere to guidelines given. Results showed significant increment to 70% patient completed testing with average testing time of 44 minutes. This implementation of written note in audiology clinic has successfully achieved the objectives by increasing number of cases successfully completed test on appointment day, reducing number for follow up, reducing testing time, and sedative drug usage. Thus, it leads to improve quality of service and patients satisfaction.