Phototherapy Service Audit: Part Two Standard 1 Referral and Assessment OK This audit is designed to support dermatology departments through a self-assessment process against the Phototherapy Standards linked below:www.bad.org.uk/shared/get-file.ashx?itemtype=document&id=4151The survey takes approximately 15 minutes to complete. Responses can be edited during entry, but the survey must be completed and saved in one sitting. OK Question Title * 1. Who pre-assesses the patients and prescribes the course of phototherapy? Consultant Specialty Grade Doctor Associate Specialist GP 1st Level Registered Nurse Nurse Chartered Physiotherapist Other (please specify) OK Question Title * 2. How long is your average referral to treatment waiting list time for ROUTINE phototherapy appointments (weeks)? 0-4 weeks 5-9 weeks 10-14 weeks 15-19 weeks 20+ weeks OK Question Title * 3. How long is your average referral to treatment waiting list time for URGENT phototherapy appointments (days)? 0-4 days 5-9 days 10-14 days 15-19 days 20+ days OK Patient Case Note Review OK Question Title * 4. Please review 20 patients from the past 12 months and provide details for each column below: Did the patient start phototherapy within 6 weeks of their routine referral to the unit? Did the patient have a full nursingphototherapist assessment prior to treatment? Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? Did the referral contain details of contra-indicators or risk factors? Did the referral specify which type of phototherapy was requested? Did the referral specify which disease was to be treated? Is the treatment record up to date? Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? Patient 1 Yes No Patient 1 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 1 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 1 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 1 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 1 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 1 Did the referral specify which disease was to be treated? menu Yes No Patient 1 Is the treatment record up to date? menu Yes No Patient 1 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 2 Yes No Patient 2 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 2 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 2 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 2 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 2 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 2 Did the referral specify which disease was to be treated? menu Yes No Patient 2 Is the treatment record up to date? menu Yes No Patient 2 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 3 Yes No Patient 3 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 3 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 3 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 3 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 3 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 3 Did the referral specify which disease was to be treated? menu Yes No Patient 3 Is the treatment record up to date? menu Yes No Patient 3 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 4 Yes No Patient 4 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 4 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 4 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 4 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 4 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 4 Did the referral specify which disease was to be treated? menu Yes No Patient 4 Is the treatment record up to date? menu Yes No Patient 4 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 5 Yes No Patient 5 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 5 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 5 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 5 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 5 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 5 Did the referral specify which disease was to be treated? menu Yes No Patient 5 Is the treatment record up to date? menu Yes No Patient 5 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 6 Yes No Patient 6 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 6 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 6 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 6 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 6 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 6 Did the referral specify which disease was to be treated? menu Yes No Patient 6 Is the treatment record up to date? menu Yes No Patient 6 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 7 Yes No Patient 7 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 7 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 7 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 7 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 7 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 7 Did the referral specify which disease was to be treated? menu Yes No Patient 7 Is the treatment record up to date? menu Yes No Patient 7 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 8 Yes No Patient 8 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 8 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 8 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 8 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 8 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 8 Did the referral specify which disease was to be treated? menu Yes No Patient 8 Is the treatment record up to date? menu Yes No Patient 8 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 9 Yes No Patient 9 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 9 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 9 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 9 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 9 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 9 Did the referral specify which disease was to be treated? menu Yes No Patient 9 Is the treatment record up to date? menu Yes No Patient 9 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 10 Yes No Patient 10 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 10 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 10 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 10 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 10 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 10 Did the referral specify which disease was to be treated? menu Yes No Patient 10 Is the treatment record up to date? menu Yes No Patient 10 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 11 Yes No Patient 11 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 11 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 11 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 11 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 11 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 11 Did the referral specify which disease was to be treated? menu Yes No Patient 11 Is the treatment record up to date? menu Yes No Patient 11 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 12 Yes No Patient 12 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 12 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 12 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 12 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 12 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 12 Did the referral specify which disease was to be treated? menu Yes No Patient 12 Is the treatment record up to date? menu Yes No Patient 12 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 13 Yes No Patient 13 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 13 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 13 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 13 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 13 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 13 Did the referral specify which disease was to be treated? menu Yes No Patient 13 Is the treatment record up to date? menu Yes No Patient 13 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 14 Yes No Patient 14 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 14 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 14 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 14 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 14 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 14 Did the referral specify which disease was to be treated? menu Yes No Patient 14 Is the treatment record up to date? menu Yes No Patient 14 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 15 Yes No Patient 15 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 15 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 15 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 15 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 15 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 15 Did the referral specify which disease was to be treated? menu Yes No Patient 15 Is the treatment record up to date? menu Yes No Patient 15 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 16 Yes No Patient 16 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 16 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 16 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 16 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 16 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 16 Did the referral specify which disease was to be treated? menu Yes No Patient 16 Is the treatment record up to date? menu Yes No Patient 16 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 17 Yes No Patient 17 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 17 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 17 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 17 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 17 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 17 Did the referral specify which disease was to be treated? menu Yes No Patient 17 Is the treatment record up to date? menu Yes No Patient 17 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 18 Yes No Patient 18 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 18 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 18 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 18 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 18 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 18 Did the referral specify which disease was to be treated? menu Yes No Patient 18 Is the treatment record up to date? menu Yes No Patient 18 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 19 Yes No Patient 19 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 19 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 19 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 19 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 19 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 19 Did the referral specify which disease was to be treated? menu Yes No Patient 19 Is the treatment record up to date? menu Yes No Patient 19 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu Patient 20 Yes No Patient 20 Did the patient start phototherapy within 6 weeks of their routine referral to the unit? menu Yes No Patient 20 Did the patient have a full nursingphototherapist assessment prior to treatment? menu Yes No Patient 20 Is there an up-to-date summary sheet in the notes which states cumulative UVB and PUVA exposures? menu N/A Yes No Patient 20 Did the referral contain details of contra-indicators or risk factors? menu Yes No Patient 20 Did the referral specify which type of phototherapy was requested? menu Yes No Patient 20 Did the referral specify which disease was to be treated? menu Yes No Patient 20 Is the treatment record up to date? menu Yes No Patient 20 Is an assessment by the phototherapist (Nurse or Physiotherapist) in the case notes? menu OK Question Title * 5. Patient Starting Doses PUVA UVB How do you decide on a patient's starting dose for: MPD Other How do you decide on a patient's starting dose for: PUVA menu MED Other How do you decide on a patient's starting dose for: UVB menu Other (please specify) OK NEXT