New Principles of Best Practice in Clinical Audit

Burgess, Robin

doi:10.4324/9781003155393

Cited by 26 publications

(28 citation statements)

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“…All along the study period, selected clinical records review and evaluation was conducted according to the NHS Institute for Clinical Excellence (NICE) methodology [ 13 ]. In this setting, AMS team implemented a jointed review of international guidelines, thus encouraging prescribers to actively participate to the revision of local SAP recommendations.…”

Section: Methodsmentioning

confidence: 99%

Antibiotic appropriateness and adherence to local guidelines in perioperative prophylaxis: results from an antimicrobial stewardship intervention

Segala

Taddei

Giovannenze

et al. 2020

Antimicrob Resist Infect Control

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Objectives Surgical antibiotic prophylaxis (SAP) represents a major indication of antibiotic consumption worldwide. The present study aims to report the results of an enabling, long-term AMS intervention conducted between 2013 and 2019 on an Italian University Hospital performing more than 40.000 surgical interventions per year. Methods SAP inappropriateness was defined according to the ASHP guidelines and divided in four main categories: indication, selection and dosing, duration, timing. Between 2013 and 2019, we conducted a continuative AMS intervention over 14 surgical departments that included enablement, review of selected clinical records and feedback. Results We collected a total of 789 SAP prescribed to 735 patients (mean age 56.7 ± 17.8y). Overall, guideline adherence improved from 36.6% (n = 149) at baseline to 57.9% (n = 221) post-intervention (P < 0.0001). A significant improvement (P < 0.001) was also detected for each category: indication (from 58.5 to 93.2%), selection and dosing (from 58.5 to 80.6%), timing (from 92.4 to 97.6%), duration (from 71 to 80.1%). Conclusions Though results cannot be generalized to all hospital populations, enabling AMS interventions may be effective in establishing a sustained improvement in SAP appropriateness rates. Once identified the main causes of SAP inappropriateness, tailored AMS interventions for each department may be beneficial. Further studies are needed to evaluate specific outcomes as incidence of surgical site infections and antimicrobial resistance.

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Section: Methodsmentioning

confidence: 99%

Antibiotic appropriateness and adherence to local guidelines in perioperative prophylaxis: results from an antimicrobial stewardship intervention

Segala

Taddei

Giovannenze

et al. 2020

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

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“…The prerequisite for the drafting of such “behavioral normalization” tools is the understanding of the initial conditions and the identification of the objectives to be pursued in terms of clinical excellence and quality of care. Therefore, a clinical audit should be carried out through a structured systematic methodology (also using tools adapted from other contexts as the SWOT analysis) so that the strengths and weaknesses of the system may be highlighted [ 36 , 37 ]. Moreover, to ensure the monitoring of assistance levels in relation to the defined objectives, the strategic direction should introduce adequate performance indicators, and promote the attitude of HCW towards proper pharmacovigilance, reporting of near-miss events, adverse events, and sentinel events related to the off-label administration of COVID vaccines [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Off-Label Use of COVID-19 Vaccines from Ethical Issues to Medico-Legal Aspects: An Italian Perspective

et al. 2021

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During the COVID-19 outbreak, the lack of official recommendations on the treatment has led healthcare workers to use multiple drugs not specifically tested and approved for the new insidious disease. After the availability of the first COVID-19 vaccines (Comirnaty Pfizer-BioNTech and Moderna COVID19 vaccine), an authorization was issued by national and international Drug Regulatory Agencies in order to speed up their introduction on the market and their administration on a large scale. Despite the authorization, the off-label use of these vaccines may still be possible especially to answer specific concerns as the lack of vaccine doses, the delay in the delivery of planned doses or the pressure from public opinion and political influence also in relation to the evolution of the pandemic. This paper aims to assess the possible off-label use of COVID-19 vaccines and the ethical and medico-legal implications of this eventuality. The scope of this paper is to point out the possible consequences of off-label use of COVID-19 vaccines and possible mitigation and preventive measures to be taken by healthcare workers involved in vaccination procedures.

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“…We performed a descriptive analysis to assess diabetes management among the residents living in nursing homes. Such methods are often preferable when investigating whether disorder management follows clinical recommendations (Burgess, 2011). A Kolmogorov–Smirnov test confirmed the irregular distribution of scores for all studied variables ( p < .001).…”

Section: Methodsmentioning

confidence: 99%

Diabetes management of older adults in nursing homes: A retrospective study

et al. 2021

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Diabetes is a significant public health problem worldwide (Corriere et al., 2013;Munshi et al., 2016) and one of the leading causes of morbidity and mortality due to heart disease and chronic kidney disease (American Diabetes Association, 2017). Worldwide, the prevalence of diabetes is increasing at an alarming rate (World Health Organization, 2020), which represents a significant health consequence for the ageing population (Kalyani et al., 2017). Approximately one-quarter of people older than 65 years have diabetes (American

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New Principles of Best Practice in Clinical Audit

Cited by 26 publications

References 0 publications

Antibiotic appropriateness and adherence to local guidelines in perioperative prophylaxis: results from an antimicrobial stewardship intervention

Antibiotic appropriateness and adherence to local guidelines in perioperative prophylaxis: results from an antimicrobial stewardship intervention

Off-Label Use of COVID-19 Vaccines from Ethical Issues to Medico-Legal Aspects: An Italian Perspective

Diabetes management of older adults in nursing homes: A retrospective study

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