This study presented an inferior picture to that found by Allberry and Fernando 7 in 2012 24% of intimate examinations in a sexual health clinic had documentation of chaperone preference. ![]() This project highlighted important points around the offer and documentation of use of chaperones during breast examination. It is more likely for a female patient to decline a chaperone if the clinician is also female 61.45%, p<0.01, CI (47.69% to 75.21%) of women who were offered a chaperone by a female clinician declined compared to 3.82%, p<0.01, CI (0.17% to 7.47%) with male clinicians 57.63% difference between sexes, p<0.001, CI (46.80% to 68.46%) ( figure 2). Complete guideline adherence in total, including cases when chaperone was declined, stood at 56.59%. ![]() In the first postintervention cycle 98.21%, p<0.01, CI (94.98% to 100%) of cases when chaperones were documented as accepted also had a valid identifier. This resulted in a significant decrease in valid chaperone identifiers for cases where chaperone was accepted. In the second postintervention cycle a year later, stamp use was not explained to clinicians. This result was replicated a year later with 74.86%, p<0.01, CI (66.41% to 83.31%) documentation of chaperone offer present. In the first postintervention cycle, 69.95%, p<0.01, CI (59.04% to 80.76%) documentation of chaperone offer was present. It then explored the use of a ‘note stamp’ to improve adherence to professional guidelines concerning chaperones. In this project, the authors aimed to investigate current offer, documentation and, thus, use of chaperones, within a major breast service unit. 9 10 Studies have also shown that many patients see the offer of a chaperone as a sign of respect from their doctor and helps build a good patient–doctor relationship. 5–8 Previous studies have highlighted how doctors’ attitudes to intimate examination may influence their use of chaperones. Recent studies have indicated insufficient use of chaperones across primary as well as secondary care. These guidelines set out the role of a chaperone as patient advocate as well as doctor protection it clarifies that chaperones should be considered if it is necessary to perform any kind of intimate examination “This is likely to include examinations of breasts, genitalia and rectum, but could also include any examination where it is necessary to touch or even be close to the patient.” 1 1–4 In the 2013 update of Good Medical Practice, Intimate Examinations and Chaperones formed a key part of the Maintaining Boundaries section. ![]() The General Medical Council (GMC), the Royal College of Nursing, the NHS Clinical Governance Support Teams and the medical defence organisations have all generated guidance around chaperoning. In the UK, medical practitioners are provided with clear professional guidance on appropriate use of chaperones. Increasingly, chaperones are seen as important from a medicolegal perspective, as protection for the clinician against unjust allegations but also being prepared to raise concerns about a clinician's behaviour and action if they deem them to be inappropriate. A medical chaperone acts as an advocate for the patient and can help patients understand exactly what is happening, and why. A medical chaperone is an impartial observer present during a consultation between a doctor or allied health professional and a patient.
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