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Out-of-Hours ENT Facilities in England

Moorthy, R., Magarey, M., Joshi, A., Jayaraj, S.M., & Clarke, P.M. (2005). J Laryngol Otol, 119, 202-6.

This article describes a survey conducted by Moorthy et al on out-of-hours (emergency, outpatient) ear, nose, and throat (ENT) services in England. The purpose of the survey was to determine whether out-of-hours ENT units had a dedicated ENT treatment room, appropriately maintained ENT equipment, and adequate staffing. The mechanism used in each unit to disinfect flexible nasal endoscopes to prevent cross-infection was also documented. Data were gathered by means of telephone calls to the fi rst on-call ENT physician in the 106 units providing out-of-hours ENT services in England.

Moorthy et al found that 101 of the 106 units surveyed (95%) had a separate ENT treatment room, and 74 of those rooms were well stocked and maintained. Sixty-two units (58%) had assistance available. The most common endoscope disinfection mechanism was use of the EndoSheath® Technology (26% of 86 units that provided disinfection data). Alcohol wipes were employed in 23% of units and glutaraldehyde in 21%.

The researchers concluded that not all ENT units in England have appropriately equipped out-of-hours facilities and that national guidelines on the minimum equipment and staff required to provide a safe and adequate out-of-hours ENT service are needed. Moorthy et al also noted that the use of EndoSheath® Technology is considered an alternative to high-level disinfection of nasal endoscopes but that such usage must be combined with intermediate level disinfection of the instruments. The authors recommended that all out-of-hours ENT units have a formal disinfection protocol for flexible nasal endoscopes and Hopkins rods that includes training of nursing and medical staff .

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