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Clinical audit

Stefanie Deeds, Stephanie Carr, Michelle Garrison, Tyra Fainstad
Telephone calls from patients can be a large source of between-visit work in outpatient clinics. A baseline audit at the study clinic identified medication refills and test results as the most common preventable calls. The authors created a dot phrase with standardized text detailing methods for refilling medications and reviewing test results and instructed providers to use it in the after-visit summary (AVS). After implementation of the AVS dot phrase, telephone calls for medications and results had an adjusted absolute decrease of 23...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
George Hruby, Thomas Eade, Louise Emmett, Bao Ho, Ed Hsiao, Geoff Schembri, Linxin Guo, Carolyn Kwong, Julia Hunter, Keelan Byrne, Andrew Kneebone
AIM: To explore the utility of prostate specific membrane antigen (PSMA)-positron emission tomography (PET)/computed tomography (CT) in addition to conventional imaging prior to definitive external beam radiation treatment (EBRT) for prostate cancer. METHODS: All men undergoing PSMA-PET/CT prior to definitive EBRT for intermediate and high-risk prostate cancer were included in our ethics approved prospective database. For each patient, clinical and pathological results, in addition to scan results including site of PSMA positive disease and number of lesions, were recorded...
April 16, 2018: Asia-Pacific Journal of Clinical Oncology
Charlotte Hespe, Lucie Rychetnik, David Peiris, Mark Harris
BACKGROUND: Quality Improvement (QI) initiatives in primary care are effective at improving uptake of evidence based guidelines, but are difficult to implement and sustain. In Australia meso-level health organisations such as Primary health care Organisations (PHCO) offer new opportunities to implement area-wide QI programs. This study sought to identify enablers and barriers to implementation of an existing Australian QI program and to identify strategic directions that PHCOs can use in the ongoing development of QI in this environment...
April 16, 2018: BMC Health Services Research
Mira Asmirajanti, Achir Yani Syuhaimie Hamid, Tutik Sri Hariyati
OBJECTIVE: To review the effectiveness of a clinical care pathway on interprofessional collaboration and quality of health service. METHOD: A review was performed of literature published from 2000 to 2015, with the following keywords: clinical pathway, care pathway, and interprofessional collaboration. RESULTS: Evidence depicted the positive results of nursing care for clients, health care professionals and facilities. The research results were implemented at different facilities using several research designs, from descriptive to experimental...
February 2018: Enfermería Clínica
Roel Geilleit, Hen Zhi Qian, Chong Chia Yin, Loh Ai Poh, Pang Nguk Lan, Gregory M Peterson, Ng Kee Chong, Anita Huis, Dirk F de Korne
BACKGROUND: Various technologies have been developed to improve hand hygiene (HH) compliance in inpatient settings; however, little is known about the feasibility of machine learning technology for this purpose in outpatient clinics. AIM: To assess the effectiveness, user experiences and costs of implementing a real-time HH notification machine learning system in outpatient clinics. METHODS: In our mixed methods study, a multidisciplinary team co-created an infrared guided sensor system to automatically notify clinicians to perform HH just before first patient contact...
April 9, 2018: Journal of Hospital Infection
Emma J Deverall, Benjamin Gilmore, Sam Illing, Roshini Peiris-John
AIM: To determine the proportion of pregnant women vaccinated with the pertussis booster in the third trimester of their pregnancy, and explore factors influencing coverage. METHODS: A clinical audit was undertaken at Rotorua hospital using electronic databases to determine pertussis immunisation among women who birthed from 25 March to 25 April, 2017 (n=111). Lead maternity carers (LMCs) were surveyed to assess knowledge of the vaccine and explore suggestions to increase vaccination coverage...
April 13, 2018: New Zealand Medical Journal
Christina K Park, Raed Alhusayen
Although most investigators would agree that including minority races in clinical trials is important, recruitment and retention may differ among these populations. The objective of this review was to perform an audit of phase III dermatologic therapy trials to determine representation for minority groups and to explore the possibility of racial allocation bias. In this review of 11 dermatology or general medicine journals in 2015-16, we did not find evidence of systemic racial allocation bias. We did however note variation in the proportion of minority races included in studies; whereas some trials had high success in recruiting minorities, many did not...
February 15, 2018: Dermatology Online Journal
O O Jolayemi, N B Moodley, V Y Kong, B Tlou, J L Bruce, D L Clarke
BACKGROUND: It is accepted surgical practice to send all appendicectomy specimens for histological examination, but the usefulness and cost associated with this practice have not been established in our setting, a tertiary hospital in KwaZulu-Natal Province, South Africa (SA). OBJECTIVES: To determine the histological diagnoses of appendicectomy specimens in our centre, and the cost of identifying an alternative histological diagnosis requiring further treatment...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
H M Cross, S Chetty, M T Asukile, H S Hussey, E B Lee Pan, L M Tucker
A high proportion of HIV-positive patients in South Africa receive concomitant efavirenz (EFV) and isoniazid (INH) therapy. EFV is metabolised in the liver via CYP2B6, and genetic polymorphism of CYP2B6 is known to result in slowed metabolism of the drug. INH is also metabolised in the liver, causing inhibition of a pathway that plays an important role in slow EFV metabolisers. Concomitant INH use therefore affects plasma levels of EFV. EFV is well known to cause neuropsychiatric side-effects on initiation, and a recent adult case series described late-onset neurotoxicity in the form of subacute ataxia and encephalopathy in patients treated with EFV for a median of 2 years, in association with toxic plasma levels of the drug...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Maurizio Dondi, Diana Paez, Leonel Torres, Mario Marengo, Angelika Bischof Delaloye, Kishor Solanki, Annare Van Zyl Ellmann, Enrique Estrada Lobato, Rodolfo Nunez Miller, Francesco Giammarile, Thomas Pascual
The International Atomic Energy Agency (IAEA) developed a comprehensive program-Quality Management Audits in Nuclear Medicine (QUANUM). This program covers all aspects of nuclear medicine practices including, but not limited to, clinical practice, management, operations, and services. The QUANUM program, which includes quality standards detailed in relevant checklists, aims at introducing a culture of comprehensive quality audit processes that are patient oriented, systematic, and outcome based. This paper will focus on the impact of the implementation of QUANUM on daily routine practices in audited centers...
May 2018: Seminars in Nuclear Medicine
Matthew F Covington, Catherine A Young, Catherine M Appleton
Accreditation through the American College of Radiology (ACR) Breast Magnetic Resonance Imaging Accreditation Program is necessary to qualify for reimbursement from Medicare and many private insurers and provides facilities with peer review on image acquisition and clinical quality. Adherence to ACR quality control and technical practice parameter guidelines for breast MR imaging and performance of a medical outcomes audit program will maintain high-quality imaging and facilitate accreditation. Economic factors likely to influence the practice of breast MR imaging include cost-effectiveness, competition with lower-cost breast-imaging modalities, and price transparency, all of which may lower the cost of MR imaging and allow for greater utilization...
May 2018: Magnetic Resonance Imaging Clinics of North America
Mathew Sandakabatu, Titus Nasi, Carol Titiulu, Trevor Duke
While maternal and perinatal mortality auditing has been strongly promoted by the World Health Organization (WHO), there has been very limited promotion or evaluation of child death auditing in low/middle-income settings. In 2017, a standardised child death review process was introduced in the paediatric department of the National Hospital in Honiara, Solomon Islands. We evaluated the process and outcomes of child death reviews. The child death auditing process was assessed through systematic observations made at each of the weekly meetings using the following standards for evaluation: (1) adapted WHO tools for paediatric auditing; (2) the five stages of the audit cycle; (3) published principles of paediatric audit; and (4) WHO and Solomon Islands national clinical standards of Hospital Care for Children...
April 4, 2018: Archives of Disease in Childhood
Abenaa M Brewster, Priya Thomas, Powel Brown, Robin Coyne, Yuanqing Yan, Cristina Checka, Lavinia Middleton, Kim-Anh Do, Therese Bevers
Background: The low uptake of antiestrogen preventive therapy among women at high risk of developing breast cancer remains a challenge. We implemented a performance improvement program to increase the uptake of preventive therapy among women with atypical hyperplasia (AH) and lobular cancer in situ (LCIS). Methods: A performance improvement program was implemented at the MD Anderson Cancer Center (Houston, TX), November 2015 to February 2017, for patients with a new (<6 months) or existing (≥6 months) diagnosis of AH/LCIS...
April 4, 2018: Cancer Prevention Research
Anna P Andreou, Michele Trimboli, Adnan Al-Kaisy, Madeleine Murphy, Stefano Palmisani, Cherylin Fenech, Thomas Smith, Giorgio Lambru
OBJECTIVES: The National Institute for Health and Care Excellence (NICE) in the United Kingdom (UK) recommend the use of OnabotulinumtoxinA (BoNTA, Botox® ) in the management of chronic migraine (CM) following specific guidelines within the National Health Service (NHS). In view of the lack of data on the efficacy of this therapy following implementation of this guidelines in clinical practice and on the evaluation of guidance' compliance, we evaluate the effectiveness and safety of BoNTA in CM patients following the NICE guidelines...
April 4, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Aliki Stamou, Athanasios Liaskas, Ioannis-Georgios Tzanninis, Eftyhia Kanioura, Dimitrios Politis, Kalliopi-Anna Poulia, Vasiliki Skarlatou, Nora-Athina Viniou, Konstantinos Konstantopoulos, Panagiotis Diamantopoulos
No abstract text is available yet for this article.
April 2018: Clinical Nutrition ESPEN
Georgina A V Murphy, Gregory B Omondi, David Gathara, Nancy Abuya, Jacintah Mwachiro, Rose Kuria, Edna Tallam-Kimaiyo, Mike English
Neonatal mortality currently accounts for 45% of all child mortality in Kenya, standing at 22 per 1000 live births. Access to basic but high quality inpatient neonatal services for small and sick newborns will be key in reducing neonatal mortality. Neonatal inpatient care is reliant on nursing care, yet explicit nursing standards for such care do not currently exist in Kenya. We reviewed the Nursing Council of Kenya 'Manual of Clinical Procedures' to identify tasks relevant for the care of inpatient neonates...
2018: BMJ Global Health
Deepak Batura, Tumaj Hashemzehi, Josie Colemeadow
PURPOSE: Intravesical chemotherapy administered within 24 h of the first resection of non-muscle-invasive bladder cancer (NMIBC) reduces recurrence rates and prolongs recurrence-free intervals. However, there is considerable variation in the use of intravesical chemotherapy amongst urologists. In our hospital, we use mitomycin C (MMC), and our usage was inconsistent. Therefore, we devised a care bundle to improve MMC usage. The objective of this study was to evaluate the effectiveness of the care bundle on postoperative MMC use...
April 2, 2018: International Urology and Nephrology
Wesley Chong, Allan Chee Yang Fong, Yi Lin Yeo, Angie Puay Hong Ng, Eileen May Lin Neo, Veronica Li Ee Sam, Jessica Kai Jun Ong, Loh Huey Peng
Aim: To reduce the number of invalid surgical consents in the Singapore National Eye Centre Day Surgery Unit over a period of 6 months. Methodology: A multidisciplinary team involving doctors, nurses, day surgery unit, operating theatre, listing and clinical audit staff looked into the listing process and the root causes of the high number of invalid consents. A Pareto chart detailing the top causes of invalid consents was drawn, and with a prioritisation matrix, feasible yet effective changes were identified and effected...
2018: BMJ Open Quality
Orna Tzischinsky, Gal Meiri, Liora Manelis, Asif Bar-Sinai, Hagit Flusser, Analya Michaelovski, Orit Zivan, Michal Ilan, Michal Faroy, Idan Menashe, Ilan Dinstein
Background: Sensory abnormalities and sleep disturbances are highly prevalent in children with autism, but the potential relationship between these two domains has rarely been explored. Understanding such relationships is important for identifying children with autism who exhibit more homogeneous symptoms. Methods: Here, we examined this relationship using the Caregiver Sensory Profile and the Children's Sleep Habits Questionnaire, which were completed by parents of 69 children with autism and 62 age-matched controls...
2018: Molecular Autism
Angela M Ingraham, M Didem Ayturk, Catarina I Kiefe, Heena P Santry
OBJECTIVE: To examine national adherence to emergency general surgery (EGS) best practices. BACKGROUND: There is a national crisis in access to high-quality care for general surgery emergencies. Acute care surgery (ACS), a specialty leveraging strengths of trauma systems, may ameliorate this crisis. A critical component of trauma care is adherence to clinical guidelines. We previously established best practices for EGS using RAND Appropriateness Methodology and pilot data...
March 30, 2018: Annals of Surgery
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