reasonably representative cross-section of this group was
sampled. The absolute denominator is not available, but
based on the population details, the approximate response
rate was 3.5%. Furthermore, observational designs like
cross-sectional studies cannot test any direct cause and
effect relationship and therefore cannot inform or make
firm recommendations for practice. Although cross-sec-
tional designs provide only a ‘‘once off’’ measurement and
do not allow for understanding of changes in practice over
time, this survey could be repeated some years in the
future to assess for practice evolution. The value of the
study’s results lies in the summary of current practice
and its ability to inform future trial work to improve
flushing practice and patient care.