Toh Alex, Mullin Annemarie, Grainger Joe, Uppal Harpreet
Department of Otolaryngology, City General Hospital, University Hospital North Staffordshire NHS Trust, Newcastle Road, Stoke-on-Trent ST4 7LN, UK.
Ann R Coll Surg Engl. 2009 Nov;91(8):697-9. doi: 10.1308/003588409X12486167521712.
Tonsillectomy is one of the most frequently performed operations in the UK. Documentation of the indications for tonsillectomy is vital, and should fulfil evidence-based guidelines where possible. We present a completed audit, evaluating the documentation of our department's practice in meeting the recommendations made by the Scottish Intercollegiate Guideline Network (SIGN) on indications for tonsillectomy.
A prospective audit of 100 children undergoing tonsillectomy for recurrent tonsillitis at a university hospital during two time periods: October 2007 to January 2008 and March to September 2008. Interventions including the production of posters and rubber stamps were agreed and implemented between the two audit periods.
Following the implementation of simple changes, significant improvements were seen in documentation relating to the SIGN guidelines for tonsillectomy. Overall, the number of children meeting all four SIGN criteria for tonsillectomy rose from 12% to 44% (chi(2) = 57.8; P < 0.001). Furthermore, a significant reduction was seen in the number of children below the age of 5 years undergoing tonsillectomy for recurrent tonsillitis (chi(2) = 14.66; P < 0.001).
With increasing scrutiny on tonsillectomy, it is important to ensure that the reasons for performing tonsillectomy are documented clearly and adhere to evidence-based guidance where possible. We have demonstrated that, with only simple and low-cost interventions, significant improvements in the documentation of tonsillectomy indications can be achieved.
扁桃体切除术是英国最常开展的手术之一。记录扁桃体切除术的指征至关重要，且应尽可能遵循循证指南。我们开展了一项完整的审计，评估本部门在遵循苏格兰校际指南网络（SIGN）关于扁桃体切除术指征的建议方面的实践记录情况。
对一家大学医院在两个时间段（2007年10月至2008年1月以及2008年3月至9月）接受扁桃体切除术治疗复发性扁桃体炎的100名儿童进行前瞻性审计。在两个审计时间段之间商定并实施了包括制作海报和橡皮图章在内的干预措施。
在实施了简单的改变之后，扁桃体切除术SIGN指南相关记录有了显著改善。总体而言，符合扁桃体切除术所有四项SIGN标准的儿童数量从12%增至44%（卡方检验=57.8；P<0.001）。此外，因复发性扁桃体炎接受扁桃体切除术的5岁以下儿童数量显著减少（卡方检验=14.66；P<0.001）。
随着对扁桃体切除术审查的日益严格，确保清楚记录实施扁桃体切除术的理由并尽可能遵循循证指南非常重要。我们已经证明，仅通过简单且低成本的干预措施，就能在扁桃体切除术指征记录方面取得显著改善。
