According to the school of medicine at the University of California (2012), there is a need to develop algorithmic pathways for best practices toward the treatment of ear, nose and throat infections. Clinical outcomes are used to measure best practices in ENT treatment. In addition, the satisfaction of practitioners and patients should also be put into consideration as best practices. In cases where available resources are inadequate, it is imperative to encourage economic use of these resources by setting priorities. Moreover, the same resources should be used optimally.
When ENT patients are admitted to healthcare centers, a prompt diagnosis should be carried out in order to save the time needed for treatment. For example, a primary care physician may not work speedily on a procedure such as nasopharyngoscopy. In such a case, a specialist in this field should be assigned the task in order to facilitate quick healthcare delivery for ENT patients. On the other hand, when a middle-level or primary care practitioner is assigned a simpler diagnosis or treatment procedure, it amounts to best practice in ENT (Berdeaux et al., 1998).
According to CRNBC (2012), it is vital for medical practitioners who are specialized in the treatment of ear, nose and throat infections to be very cautious when handling patients, especially during their first hospital admissions. This precaution has been found to be integral in the sense that hospital re-admissions are costly to healthcare establishments. Therefore, the ear, nose and throat patients should be assessed thoroughly before any form of treatment is administered.
To begin with, the system review and history of current illness should form the basis of best practice in the ear, nose and throat treatment. It is necessary to explore and elicit the features of all the signs and symptoms such as chronology, the present situation of the admitted patient, impacts of regular activities, suitability and efficiency of past treatments. Moreover, location of the patient, nature of the onset of the infection (whether it is gradual or abrupt), aggravating and precipitating factors, past treatments, the severity of the condition as well as any other relieving factor should be considered (CRNBC, 2012).
In addition to the above overall measures of best practices, a medical practitioner should go further and understand the specific symptoms that are integral in the diagnosis. Some of the specific factors include Q-tip use, vertigo, presence of itching, painful feelings either inside or outside the ear, the efficiency of the hearing aid, discharge from the ear or nose as well as any other latest alterations in the hearing mode of the patient. The aforementioned specific symptoms are necessary so that an ENT expert can narrow down the actual causes and development of the infection. In cases where best practices of these magnitudes are not followed, wrong diagnosis and consequent ineffective treatments are inevitable.
The College of Registered Nurses of British Columbia (CRNBC) is one of the institutes that adhere to best practices in ear, nose and throat treatment. CRNBC has the obligation of making sure that all the registered nurses are certified and also operate within the set guidelines similar to many other medical organizations in this industry.
In terms of the nose and sinuses, principles of best practices stipulate that specific symptoms should entail the presence of watery eyes, incessant sneezing, incidents of rhinorrhea, nasal pains, associated trauma, localized headache, anosmia and epistaxis.
While the target part is the throat, it is worth to mention that the adjacent regions such as the mouth and neck may also show physical symptoms during diagnosis. Therefore, the unique signs and symptoms that should be examined around the throat and mouth include dysphagia, recent changes in the quality of voice, uvula, midline, deep sore pains around the throat, weak gums that bleed especially during brushing, dental instability and oral lesions (CRNBC, 2012). The patient may also complain of some pains in the neck due to glands that have been enlarged and consequently swollen. These symptoms are also known to worsen the general wellbeing of a patient in the sense that he or she may experience vomiting or nausea from time to time. In addition, the patient may encounter malaise with a body temperature above normal as a result of fever. In cases where best medical practices are not exercised, it is possible for a clinician to confound these symptoms with those of other ailments.
The second consideration to make when diagnosing a suspected ENT patient is an adequate examination of the medical history. Some of the general points of considerations under medical history include whether the patient has ever undertaken past surgeries, the general medical condition of a patient, use of traditional therapies and herbal extracts in the past, whether the patient is under any current form of medication (such as over the counter prescriptions or birth control pills) and finally, whether the patient has any allergies. In any form of best medical practice, the medical history of a patient is paramount during diagnosis and eventual treatment because the onset of most medical complications can often be traced from past medical records (Stephen et al., 2010).
Some of the specific medical history records that are related to the ear, nose and throat infections include loss of hearing, difficulty in breathing as occasioned by asthma, surgery related to the ear, nose or throat, some form of trauma around the ear, nose, throat or the head in general, sinusitis, regular infections around the throat or ear and past screening results which demonstrate that a patient has been suffering from loss of hearing. In addition, there is also some likelihood for a patient to contract cancerous cells around the ear, nose and throat (André, 1995).
Although the above-mentioned best practices in the diagnosis of ENT complications are fundamental towards proper treatment, it is essential to bear in mind that urgent referral of a patient is necessary in cases where the current healthcare establishment lacks adequate equipment or expertise. If the ear, nose and throat infections that have been presented demand immediate referral, then it is highly advisable for such a step to be taken without much delay (Buss, 2011). A case can be referred to a nurse practitioner or physician if the signs and symptoms depicted in the initial diagnosis include vertigo that cannot be easily explained, hoarseness of the voice of the patient in the absence of any illness or fever if the patient has undergone any recent surgery of the ear, nose or throat if the region from the chest to the chin shows positive Brudzinsky symptoms and also if tenderness is felt around the mastoid amidst fever and pain (Estes & Zator, 2010). A patient can also be booked for referral if he or she is experiencing random feverish pains with an unknown source. Referrals may also have opted if there is no positive response after treating ENT complications such as peritonsillar abscess and strep throat for three days. Finally, in the event that epistaxis cannot be controlled or managed, it is highly recommended for a patient to be referred as soon as possible (André, 1995).
References
André, M.J. (1995). Infections of the Ear, Nose and Throat. Essentials of Infectious Diseases. Oxford: Blackwell Scientific Publications.
Berdeaux, G. et al. (1998). Parental quality of life and recurrent ENT infections in their children: Development of a questionnaire. Quality of Life Research, 7(6), 501- 512.
Buss, J. (2011). Health Assessment Made Incredibly Visual! (2nd Ed.). Ambler, PA: Lippincott, Williams and Wilkins.
CRNBC (2012). Adult decision support tool: Ear, Nose and Throat assessment. Web.
Estes, M. & Zator, E. (2010). Health Assessment & Physical Assessment, (4th Ed.) Clifton Park, NY: Delmare, Cengage Learning.
Stephen, T. et al (2010). Canadian Bates’ Guide to Health Assessment for Nurses. Philadelphia, PA: Lippincott, Williams and Wilkins.
University of California (2012). Ambulatory Healthcare Pathways for Ear, Nose, and Throat Disorders. Web.