临床审计:必要还是形式?

Sami Ajaz, Muhammad Ahmad, RAZA SARFRAZ
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摘要

临床审计是世界范围内广泛接受的一种实践,用于评估提供者提供的医疗保健质量(1)。它被描述为一种质量改进方法,旨在通过系统地检查规定的标准和实施变革的治疗来提高患者护理和结果(2)。临床审计提供的服务具有识别缺陷、卓越领域的能力,并产生相关建议,从而推动变革。它加强了对既定标准进行评估的实践(1)。在发达国家,它是临床实践的重要组成部分;然而,它尚未在发展中国家取得平等地位。因此,对结构化临床审计项目的需求早就应该出现了。令人惊讶的是,从2021年至今,在PakMediNet和PubMed上进行了全面的在线文献检索,仅在巴基斯坦获得了三项临床审计研究,如表1所示。所有这些研究都是闭环审计,遵循准确的指导方针,并报告了在重新审计周期干预后的显着改善。Ashraf M等人报道,通过审计来识别贫困地区,可以改善手术记录(3)。Shah MH等人认为,没有遵循标准静脉血栓栓塞(VTE)风险评估和预防性处方指南,但经过干预和重新审计,发现简单有效的教育干预可以改善VTE风险评估和预防性处方实践(4)。Rabbani RA等人强调在改进标准外科手术过程中需要临床审计(5)。毫无疑问,临床审计是一种工具,如果使用正确,可以导致服务提供的护理质量发生变化(1)。新的研究和临床审计项目对巴基斯坦优质护理的未来至关重要(2)。至关重要的是,我们未来的卫生保健工作者了解如何进行临床审核并在培训期间指导他们(2)。通过将频繁的审核与临床实践结合在课程中,卫生保健单位可以实现持续改进。临床审计有助于加强和提高他们的临床知识和沟通能力。在一天结束的时候,它将导致改善病人的护理和结果。因此,需要的时间是促进临床审计研究的医护人员。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical audit: a necessity or a formality?
Dear Editor, Clinical auditing is a widely accepted practice world wide to assess the quality of health care given by a provider (1). It is described as a quality improvement approach that aims to enhance patient care and outcomes by systematically examining of treatment against stated criteria and implementing change (2). A clinical audit provides a service with the capacity to identify deficiencies, areas of excellence, and generate relevant suggestions that would drive change. It enhances the practice of evaluating against established standards (1). In developed countries, it is an essential component of clinical practice; nevertheless, it has yet to achieve equal status in developing countries. As a result, the demand for a structured Clinical Audit program is long overdue. Surprisingly, a thorough online literature search from 2021 till date was conducted on PakMediNet and PubMed that yielded only three clinical audit studies in Pakistan as shown in Table - 1. All these studies are closed-loop audits that follow accurate guidelines and reported significant improvement after intervention in the re-audit cycle. Ashraf M et al. reported that operative notes can be improved, by using audits to identify poor areas (3). According to Shah MH et al. standard venous thromboembolism (VTE) risk assessment and prophylactic prescription guidelines were not followed, but after intervention and re-audit, it was discovered that a simple and effective educational intervention improved VTE risk assessment and prophylactic prescribing practices (4). Similarly, Rabbani RA et al. emphasize the need for clinical audits in improving standard surgical procedures (5). No doubt that clinical audits are a tool that, when used correctly, can result in a change in the quality of care provided by a service (1). New research and clinical audit programs are crucial to the future of quality care in Pakistan (2). As a result, it is critical that our future healthcare workers understand how to conduct clinical audits and lead them during their training (2). Continuous improvement can be achieved by a healthcare unit that incorporates frequent audits with clinical practice in its curriculum. Clinical auditing will help to strengthen and increase their clinical knowledge and communication abilities. At the end of the day, it will result in improved patient care and outcomes. Therefore, the need of the hour is to promote clinical audit studies among healthcare workers.
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