PubMed · 10314363
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R J Arnold. Bridging the educational gap.. https://pubmed.ncbi.nlm.nih.gov/10314363/
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Thyroid carcinomas may originate in the thyroid cells (follicular and papillary, carcinoma, so-called differentiated carcinomas, constituting roughly 80-90% of cases), and the calcitonin-producing parafollicular C cells (medullary carcinoma, roughly 10%). The suspected diagnosis is clarified with the aid of ultrasonography, scintigraphy and fine-needle aspiration cytology. Primarily, carcinomas of the thyroid are treated surgically; in the case of differentiated carcinomas, surgery is followed by radio-iodine treatment, and in the follow-up period 131I scintigraphy is performed. During this period, physical examination, ultrasonography of the neck, monitoring of the tumours markers, and treatment with levothyroxine are applied (TSH-suppressive in cases of differentiated carcinoma). In the event of a recurrence showing rapid progression, when surgical and nuclear medical treatment modalities have been exhausted, chemotherapy can be given.
We investigated the value of a full-time audit nurse personally following up every patient from admission to 30 days postoperatively in order to obtain accurate surgical wound infection rates. Our results show that this type of audit is an effective, although time-consuming, way of collecting accurate data on wound infection rates. It enabled the early identification of problem areas in practice and facilitated the adoption of evidence based practice. As a result of the audit there was a significant reduction in the clean wound infection rate from 13.9% in November 1995 to 7.9% in March 1998 (P= 0.05).