This paper describes the content and administration of Monitor and Senior Monitor and the difficulties encountered, together with suggestions for avoiding or overcoming these difficulties. This work forms part of a study, funded by the Department of Health, which is examining the reliability and validity of the quality assessment instruments, Monitor, Senior Monitor and QualPacs. The instruments were administered in care of the elderly, medical and surgical wards in two Health Authorities in London. Difficulties encountered with the administration of Monitor and Senior Monitor were to do with the structure of the instruments, accessing required information, interpreting questions and answers, disrupting ward staff, the time required to carry out the procedure and frustrations experienced by the assessors. Although the number of difficulties encountered was considerable, they were not insurmountable. The authors are confident that awareness of these difficulties, and taking steps beforehand to avoid or overcome them, contributes to the reliability and validity of these instruments.
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