Standard 15: Optical and Hearing

Why this criterion matters. A sight or hearing test that uses an unvalidated method or poor equipment gives the wrong answer, and the patient is fitted with the wrong product. The test is the start of every correct fitting.

Sample. Review 30 sight and hearing test records in the last 6 months, and the calibration records for the equipment used.

1. Each test uses a validated method, named on the record.

Method. Check each record for the named method.

Evidence to show. Sight and hearing test record (OPT-FRM-001).

Pass when. Every test names a validated method.

2. Test equipment is in calibration on the day of the test.

Method. Check the calibration date of the equipment used for each sampled test.

Evidence to show. Equipment inventory and service log (EQP-REG-001).

Pass when. Every test used equipment in calibration.

3. Each finding that needs referral is referred.

Method. Check each record with a referral finding for the referral made.

Evidence to show. Sight and hearing test record.

Pass when. Every finding that needs referral has a referral recorded.

Immediate fail (any one means the criterion is not met)

• A test is given with an unvalidated method or with equipment past calibration.

Why this criterion matters. Sight testing, dispensing and hearing aid fitting each need their own qualification. A person without the right one can give a patient the wrong product with the wrong advice.

Sample. Review the qualification register for all staff who test sight, dispense or fit hearing aids, and the records of work done by each in the last 12 months.

1. Each person is qualified for each task they carry out.

Method. Check each task in the records against the person's qualification for that task.

Evidence to show. Qualification register (OPT-REG-002).

Pass when. Every task is carried out by a person qualified for it.

2. Each qualification is verified and current.

Method. Check each entry for verification date and expiry.

Evidence to show. Qualification register.

Pass when. Every qualification is verified and current.

3. Staff without a qualification for a task are supervised.

Method. Check the supervision entry for any person without a qualification for a task.

Evidence to show. Qualification register.

Pass when. Every such task is supervised and recorded.

Immediate fail (any one means the criterion is not met)

• A person without the qualification tests sight or fits a hearing aid alone.

Why this criterion matters. A spectacle, contact lens or hearing aid that does not fit correctly causes headache, damage or loss of benefit. Fitting and checking each product is what makes it safe to wear.

Sample. Review 30 fittings in the last 6 months, including spectacles, contact lenses and hearing aids.

1. Each product is fitted to the measured need.

Method. Check each fitting record for the measurement and the product.

Evidence to show. Fitting and fit check record (OPT-FRM-002).

Pass when. Every fitting has a measured need recorded.

2. The fit is checked with the patient before they leave.

Method. Check each fitting for the fit check and its time.

Evidence to show. Fitting and fit check record.

Pass when. At least 95% of fittings have the fit checked before the patient leaves.

3. A product that does not fit is adjusted or not given.

Method. Check each recorded misfit for the adjustment or the decision.

Evidence to show. Fitting and fit check record.

Pass when. Every misfit is adjusted or not given.

Immediate fail (any one means the criterion is not met)

• A product is given before its fit has been checked with the patient.

Why this criterion matters. Contact lenses and hearing aids can cause infection if they are not cleaned and cared for correctly. Patients taught the right care keep themselves safe between visits.

Sample. Review the hygiene teaching records for 20 contact lens and hearing aid users in the last 6 months.

1. Each user is taught hygiene and care for the device.

Method. Check each user record for the teaching.

Evidence to show. Device hygiene teaching record (OPT-FRM-003).

Pass when. At least 95% of users have the teaching recorded.

2. The teaching is checked with the patient.

Method. Check each record for the patient showing or saying back the steps.

Evidence to show. Device hygiene teaching record.

Pass when. At least 90% of records show the check.

3. The teaching is repeated at each review.

Method. Check the review records for a repeat of the teaching.

Evidence to show. Device hygiene teaching record.

Pass when. At least 90% of reviews include the repeat teaching.

Immediate fail (any one means the criterion is not met)

Why this criterion matters. A product that is fitted once is not finished. Adjustment, review and follow-up after the fitting are where most problems are found and fixed.

Sample. Review the aftercare records for 20 product fittings in the last 6 months, and each problem reported.

1. Each patient has a follow-up booked for adjustment and review.

Method. Check each fitting for the follow-up booked.

Evidence to show. Aftercare and follow-up record (OPT-FRM-004).

Pass when. At least 95% of fittings have a follow-up booked.

2. Each patient has a named contact for problems.

Method. Check each record for the named contact given.

Evidence to show. Aftercare and follow-up record.

Pass when. Every patient has a named contact recorded.

3. A reported problem is seen within the set time.

Method. Check each reported problem for the time of response.

Evidence to show. Aftercare and follow-up record.

Pass when. At least 90% of problems are seen within the set time.

Immediate fail (any one means the criterion is not met)

• A patient is given a product with no follow-up booked and no named contact.

Why this criterion matters. A complaint about a product or a service is information about what is going wrong. Recording and acting on it, and telling the patient what was done, improves the service.

Sample. Review every complaint about a product or service in the last 12 months.

1. Each complaint is recorded.

Method. Compare the complaints log with the complaints received in the period.

Evidence to show. Product complaint record (OPT-FRM-005).

Pass when. No complaint is missing from the record.

2. Each complaint is reviewed and acted on.

Method. Check each complaint for the review and the action.

Evidence to show. Product complaint record.

Pass when. Every complaint has a review and an action recorded.

3. The patient is told the outcome.

Method. Check each complaint for the outcome told and its date.

Evidence to show. Product complaint record.

Pass when. At least 95% of complaints have the outcome told.

Immediate fail (any one means the criterion is not met)

Why this criterion matters. Sudden loss of vision or hearing can be a sign of a serious condition that needs care the same day. Staff who recognise it, and refer at once, can prevent permanent loss.

Sample. Review the urgent referral records for the last 12 months, and the staff training record for recognising urgent eye and ear conditions.

1. Staff are trained to recognise sudden loss of vision or hearing.

Method. Check the training record for each clinical member of staff.

Evidence to show. Training matrix register (WRK-REG-001).

Pass when. Every clinical member of staff has the training recorded.

2. Each urgent patient is sent the same day to emergency care.

Method. Check each urgent case for the referral on the same day.

Evidence to show. Urgent eye and ear referral record (OPT-FRM-006).

Pass when. Every urgent case is referred the same day.

3. The patient is confirmed to have reached care.

Method. Check each referral for the confirmation.

Evidence to show. Urgent eye and ear referral record.

Pass when. Every referral has the confirmation recorded.

Immediate fail (any one means the criterion is not met)

• A patient with sudden loss of vision or hearing is not referred the same day.