Ferris defined Clinical Audit as the comparison of the actual clinical practice against the agreed and documented evidence-based standards in an effort of improving the level of patient care as cited in ACGW and Daly ,p. Importance of Clinical Audit There are several reasons as to why a clinical audit is crucial in clinical practice.
Health Clinical Audit is a tool used to examine the practices of health care professionals implemented in a health care environment. Audit has many benefits: Clinical Governance was introduced by the British government in Meal et al, Taylor and Jones recognise clinical governance as the framework that ensures that NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will develop.
The introduction of Clinical Governance National Assembly Wales, cited by Donaldson and Mullally, has placed increased emphasis on the use of audit to measure the implementation of policies and procedures relating to infection control.
Clinical governance is about changing the way people work; demonstrating that leadership, teamwork and communication is as important to high quality care as risk management and clinical effectiveness Tait, Tait also states that clinical governance requires changes at three levels: Before carrying out an audit, the reasons for and benefits of carrying it out should be identified.
Audits are carried out to ensure that practices are safely provided and evidence-based using current research. In order to undertake an audit, staff must be informed of the process of audit.
|CLINICAL AUDIT REPORT Research Paper – Nursing Essay Papers||Closs and Cheater mentioned that audit become the backbone of one of the most commonly applied and widely tested initial methods of achieving quality improvement or attempting to facilitate the adoption of evidence-based practices.|
Staff willing to carry out an audit must be educated on the process of audit, thus they should have an understanding of the stages of clinical audit. The author will proceed to discuss the stages of audit with reference to a clinical audit that was carried out while on clinical placement in the general setting.
There are five stages of clinical audit. The first stage is to choose a topic for audit. In order to select a relevant topic the auditor must consider a few questions such as: Is the topic a priority for the organisation?
Is the problem concerned amenable to change?
Is it a situation that can be improved with a responsible amount of time and effort? The topic selected for audit must be related to patient well-being. For the purpose of this assignment the topic of effective hand washing was chosen for audit.
Prior to undertaking the audit, permission from patients, medical staff, nursing staff, healthcare assistants and house-keeping staff was obtained verbally.
In the case of any medical procedure including clinical audit, informed consent must always be acquired Van Dokkum, The second stage of the audit process is agreeing or reviewing standards. By working against either local or national standards, audit can prove effective in revealing practice that is either compliant or non-compliant.
Before carrying out the audit, the author researched some relevant literature that contributed to the standard that was set for the audit.
The World Health Organisation recommends hand-washing at five different points in contact with a patient: A study by Golan et alillustrates that hand hygiene compliance among nurses is lower than expectations.
The standard set by the National Institute of Clinical Excellence NICEis that hands must be decontaminated immediately before each and every episode of direct patient contact or care and after any activity or contact that could potentially result in hands becoming contaminated, and also that hands must be decontaminated, preferably with an alcohol-based hand rub unless hands are visibly soiled, between caring for different patients, or between different care activities for the same patient.
According to Girou et alan alcohol-based solution is significantly more efficient in reducing hand contamination than antiseptic soap. These standards where used by the student to devised an audit eligible to measure them efficiently.
In stage three of the audit, the assigned examiner in accordance with the audit tool must collect data from current practice.
This data has to be as understandable as possible to achieve the correct results. The most effective way to audit is to develop a questionnaire that can assess a situation effectively.
When developing an audit tool, it is important to keep it simple. Complex questions will over-complete the audit procedure and lead to inaccurate findings. The questions chosen for the audit tool where: Do nursing staff use the correct procedure for decontaminating hands?
Do nursing staff thoroughly dry hands after decontamination? Is hand hygiene performed prior to patient contact?Medical audit later evolved into clinical audit and a revised definition was announced by the NHS Executive: “Clinical audit is the systematic analysis of the quality of healthcare, including the procedures used for diagnosis, treatment and care, the use of resources and the resulting outcome and quality of .
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