Tympanometry by nurses--can allocation of tasks be optimised?

Acute otitis media and secretory otitis media are the most common pediatric infectious disease with a substantial impact on especially primary health care. If nurses could perform and interpret tympanometries, family practitioners workload could be reduced. We wanted to investigate the ability of nurses to perform tympanometry and evaluate the amount of training required.

Prospective study comparing results from tympanometry with results at myringotomy at a University Central Hospital was conducted. Nurses at the Paediatric Ear, Nose, and Throat Department performed tympanometry prior to myringotomy. Sensitivity and specificity of tympanometries versus myringotomy were calculated. Nurses' opinions about tympanometry and training required were evaluated.

During a 1-year period, 199 children were enrolled in the study and 392 tympanograms were analyzed. Sensitivity of tympanograms to detect middle-ear fluid was 0.54, and specificity 0.82. Secretion occurred in 22.5% of children with type A curves and 45.3% of those with type C curves. Nurses evaluated their training in tympanometry as adequate. CONSCLUSIONS: A single training session in tympanometry is inadequate to qualify nurses to perform tympanometry independently. Thorough research and testing to evaluate the quality of such training is required to produce reliable tympanograms.