Otolaryngology Department, Oxford University NHS Foundation Trust, Headley Way, Oxford, OX3 9DU, UK.
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Eur Arch Otorhinolaryngol. 2021 Jul;278(7):2641-2648. doi: 10.1007/s00405-020-06458-x. Epub 2020 Nov 6.
As surgical specialties now begin the graduated return to elective activity and face-to-face clinics, this paper investigates the current head and neck outpatient practices across the United Kingdom.
A cross-sectional study comprised of an online 20-item survey was distributed to members of the British Association of Head & Neck Oncologists (BAHNO). The survey was open on a web-based platform and covered topics including safety measures for patients, protective equipment for healthcare staff and protocols for the use of flexible nasendoscopy in the clinic.
The survey was completed by 117 participants covering 66 NHS Trusts across the UK. There was a significant reduction in face-to-face Otolaryngology, Maxillofacial and Speech and Language clinic patients when compared to pre-pandemic numbers (p < 0.0001). Risk assessments for flexible nasendoscopy were done for 69% of clinics and 58% had an established protocol. Room downtime after flexible nasendoscopy ranged from 0 to 6 h and there was a significant increase in allocated downtime after a patient had coughed/sneezed (p < 0.001). Natural ventilation existed in 36% of clinics and the majority of responders didn't know the Air Change Per Hour (ACPH) of the clinic room (77%). Where ACPH was known, it often did not match the allocated room downtime.
There is a wide variation in outpatient activity across the United Kingdom, but adaptations are being made to try and maintain staff and patient safety. However, more can still be done by liaising with allied teams to clarify outpatient protocols.
随着外科专业现在开始逐步恢复选择性活动和面对面门诊，本文调查了英国目前的头颈部门诊实践。
一项横断面研究包括一项在线 20 项调查，分发给英国头颈部肿瘤学家协会（BAHNO）的成员。该调查在一个基于网络的平台上开放，涵盖了包括患者安全措施、医护人员防护设备以及在诊所使用灵活鼻内镜的协议等主题。
共有 117 名参与者完成了涵盖英国 66 个 NHS 信托基金的调查。与大流行前相比，面对面的耳鼻喉科、颌面和言语语言诊所患者显著减少（p<0.0001）。对灵活鼻内镜检查的风险评估在 69%的诊所进行，58%有既定的协议。灵活鼻内镜检查后房间停机时间从 0 到 6 小时不等，患者咳嗽/打喷嚏后分配的停机时间显著增加（p<0.001）。36%的诊所采用自然通风，大多数应答者不知道诊所房间的每小时空气交换次数（ACPH）（77%）。在知道 ACPH 的情况下，它通常与分配的房间停机时间不匹配。
英国的门诊活动存在广泛的差异，但正在采取措施尝试保持员工和患者的安全。然而，通过与联合团队联系以澄清门诊协议，还可以做更多的工作。
