Nursing students' knowledge of and performance in communicating with patients with hearing impairment.

AIM: The present study aimed to investigate nursing students' knowledge of and performance in communicating with patients with hearing impairment. METHODS: A cross-sectional study was conducted on all senior nursing students (n = 71) in a nursing school in Iran in 2013. Data collection was performed with a demographics questionnaire, knowledge questionnaire, and performance assessment checklist. Two stages were designed to evaluate the students. In the first stage, students conducted an interview with a simulated patient with hearing impairment who experienced chest pain. In the second stage, students answered the knowledge questionnaire. Descriptive statistics, independent sample Student's t-test, and Pearson correlation coefficient were used to analyze the data. RESULTS: In total, 11.3% of participants had a history of caring for a patient with hearing impairment. The majority of students evaluated their performance in communicating with such patients at a moderate level. A significant difference was observed between the mean score of knowledge in men and women (P = 0.05), and male students gained higher scores. In total, 61.5% of the students had low to very low levels of knowledge and 87.3% of them had weak to very weak performance in communicating with patients with hearing impairment. CONCLUSION: Nursing students are lacking in knowledge and skills required for effective communication with patients with hearing impairment. Nurse educators should pay more attention to this issue as it is their responsibility to prepare nurses who are competent to deal with common issues they will face in practice.

Hearing-screening record-keeping practices at primary healthcare clinics in Gauteng.

OBJECTIVES: As little is known about hearing screening practices at primary healthcare (PHC) clinics in South Africa, the study aimed to describe hearing-screening and record-keeping practices of nurses during typical immunisation sessions at PHC clinics in Gauteng, South Africa. METHODS: Data were obtained through observations (N2 = 80) and questionnaires (N1 = 20) which were then cross-checked with retrospective information collected from the Road-to-Health Charts and City of Johannesburg Child Health Services Blue Cards of children observed during typical immunisation sessions. RESULTS: A key finding of this study was that PHC nurses who participated in this study do not adhere to the hearing-screening record-keeping practices as outlined by the national Department of Health. CONCLUSIONS: Poor record-keeping practices hinder the efficacy of hearing-screening programmes. Accurate record keeping is important in order to document outcomes which can be used to evaluate service delivery and the efficacy of hearing-screening programmes.

Routine hearing screening in primary care for adult populations using distortion product Otoacoustic Emissions testing.

PURPOSE: The purpose of this study was to determine the prevalence of undiagnosed hearing loss in adults in two busy primary care rural health centers. DATA SOURCES: Using Otoacoustic Emissions (OAE) testing, participants were screened for hearing loss by trained personnel. Participants were those who presented to the primary care provider with complaints other than hearing loss or ear problems. CONCLUSION: Of the 86 participants, 48.8% were found to have failed OAE testing, indicating some type of undiagnosed hearing loss. The average age of the participants was 49.27 years, yet nearly half had hearing loss. This finding makes hearing screening in the adult population, other than the elderly, an important issue. IMPLICATIONS FOR PRACTICE: Hearing loss affects over 40% of the adult population. Undiagnosed and untreated hearing loss can be associated with depression, decreased social activities, and low self-esteem. The project identified the need for routine hearing screening and thus may become the foundation for the development and implementation of a hearing-screening program for primary care. The primary care nurse practitioner needs to incorporate hearing screening into the exam for early identification and for proper referral.

Hearing evaluation in pediatric patients treated at the hospital following head injury.

The purpose of this study was to assess the results of a hearing evaluation protocol among 130 pediatric patients with a head injury. Sixteen of these patients failed an audiology evaluation. Ten were thought to have failed based on congestion/middle ear dysfunction, while 6 patients had temporary or permanent hearing loss thought to be related to their injury. The majority who failed because of their injury had temporal bone fractures and abnormal visual ear examination results. More research on trauma-related hearing loss following various types of head injuries and skull fractures in pediatric patients of varying ages is needed.

Efficacy of the U.S. Army policy on hearing conservation programs.

Changes in U.S. Army hearing conservation policy require that many previous non-noise hazardous areas be reclassified as noise hazardous and that employees in these areas be included in hearing conservation programs. The purpose of this study was to determine if a group of employees affected by this policy suffered occupational hearing loss between 1987 and 2001 while working in previously classified noise hazardous areas. The 45 subjects included in the study were demographically similar to the 211 from which they were selected. Differences between measured and predicted hearing thresholds in 1987 and in 2001 did not change significantly over the 15 years. Predicted noise-induced thresholds in 2001 calculated from average noise exposures were not clinically significant. It was concluded that these subjects were adequately protected from hearing loss under the previous classification criteria and application of the new criteria provided no additional benefit.

A nurse-led ear care clinic: sharing knowledge and improving patient care.

This article covers the nursing role within an ear care clinic in the hospital setting. The range of conditions managed in the clinic are listed and some of the current issues affecting ear care and ear, nose and throat (ENT) are discussed. The author conveys her enthusiasm for the appropriate management of wax encouraging colleagues to appreciate the negative affect wax impaction can have on patients. Hearing impairment is briefly mentioned and a screening list is provided to assess the hearing of older adults. Patient care is discussed and there are suggestions for the improvement of the provision of ear care within the community. The nurse practitioner discusses how to facilitate the sharing of knowledge with community practitioners. Study seminars, publications, the use of the hospital intranet site, treatment and discharge summaries can all be used to communicate new developments in patient care.

Auditory neuropathy: a potentially under-recognized neonatal intensive care unit sequela.

Auditory neuropathy (AN) is a hearing disorder that affects newborns. Those with high-risk neonatal histories, family history of childhood hearing loss, and hyperbilirubinemia are at greatest risk. Current neonatal intensive care unit (NICU) hearing screening methods that rely only on otoacoustic emissions will fail to detect this disorder. Auditory neuropathy differs from conductive hearing loss and sensorineural hearing loss; a specific constellation of findings on audiologic evaluation are diagnostic of this disorder. The pathophysiology of AN is unclear; however, it may be caused by demyelinization or degeneration at points along the auditory pathway. The actual incidence of AN is unknown; it is more prevalent in high-risk infants. The course of AN varies widely among patients. Current management ranges from close monitoring of the child's development to cochlear implantation. Neonatal intensive care unit nurses need to be aware of this disorder to help support and educate at-risk families and to alert them of the need to monitor hearing and language development in their infants.

A nurse-managed universal newborn hearing screen program.

Hearing loss is one of the most common major birth defects, yet the average age for identifying significant hearing loss in children in the United States is 30 months. Hearing loss directly affects a child's ability to develop normal language skills, impairs his or her ability to communicate with others in the environment, and has been shown to correlate with poor academic performance. However, if hearing loss is detected early and interventions are begun before 6 months of age, children with hearing loss develop language, cognitive, and speech skills comparable to their non-hearing-impaired peers. Only 38 states mandate universal newborn hearing screening before discharge from the hospital. This article describes an institutional universal hearing screening program developed by nursing, which collaborated with physicians, audiologists, and otolaryngologists. Careful planning, including a thorough literature review, networking with area hospitals, and dialoging with experts in the field led to a successful program.The outcomes from this program compare favorably to nationally published data.

A communication protocol to help patients with sensory impairment.

Patients with sight, hearing and speech impairment are entitled in law to equal access to health care according to the Disabilities Discrimination Act. More and more patients experience these problems as the population grows older. This paper reports on how a group of staff in one trust helped set up a protocol to ensure that this group's communication needs are tackled.