Effectiveness of Audit and Feedback in Improving the Quality of Operative Notes - A Retrospective Observational Study

2019 ◽  
Vol 41 (1) ◽  
pp. 75-78
Author(s):  
Leison Maharjan ◽  
Aditya Singhal ◽  
Rajendra P S Guragain
Keyword(s):  
Operation Time ◽  
Audit And Feedback ◽  
Scrub Nurse ◽  
Patient Identification ◽  
Safe Patient Care ◽  
The Status ◽  
Postoperative Diagnosis ◽  
Operative Findings ◽  
Operative Notes

Introduction: Surgeons must maintain detailed and accurate operative notes as it is important not only for safe patient care but also for research, audit and medicolegal purposes. But literature has shown that many operative notes are incomplete and illegible. Audit and feedback is a useful strategy to improve such practices which our department has been following. Our aim is to study its effectiveness by comparing the quality of operative notes of 2016 with that of 2014. Methods: Total 96 operative notes, 48 each of the year 2014 and 2016 were studied under 22 parameters including 18 suggested by “Good Surgical Practice” guideline. Each operative notes was analyzed by a single observer for completeness. Parameters of the operative notes of two different years were compared and given the status of either improved, deteriorated or unchanged. Results: Only parameters related to patient identification, date, surgeon’s fullname, postoperative plan were complete in both the years. In comparison to earlier year, in 2016 improvement was seen in parameters such as postoperative diagnosis, details of tissue removed, authors details, closure details, operation time and operative difficulties/ complications and deterioration was seen in hospital number, preoperative diagnosis, procedure, fullname of anesthetist, fullname of scrub nurse, operative findings and signature of the surgeon. Conclusion: Improvement in the quality of the operative notes was not adequate with audit and feedback strategy alone. Hence to increase the effectiveness, other methods such as computerized operative notes and aide-memoire should also be introduced.  

scholarly journals Application of Improved Eclat Algorithm in Students’ Evaluation of Teaching

2018 ◽  
Vol 228 ◽  
pp. 01017
Author(s):  
Yuzi Dou ◽  
Xiwei Fei ◽  
Rui Zhu ◽  
Tianzhu Gao ◽  
Yanbing Wu ◽  
...  
Keyword(s):  
Association Rules ◽  
Evaluation System ◽  
Operation Time ◽  
Evaluation Data ◽  
Comprehensive Information ◽  
The Status ◽  
Evaluation Of Teaching ◽  
Core Issues ◽  
The Evaluation System

The evaluation system of students is to find a way to solve the status way according to the exact needs of students and the teaching requirements of teachers, so as to improve the teaching level of teachers and improve the quality of school education. This paper uses the real evaluation sample and uses the data mining association rule algorithm to comprehensively analyze the massive data of the evaluation data and the basic information of the teacher. The purpose is to obtain the association rules between the teacher’s comprehensive information and its evaluation results. Using the evaluation data to explore its core issues. In this paper, the Eclat algorithm of association rules improves the problem of insufficient memory and occupying a large amount of time when searching for frequent itemsets in the data. The breadth-first algorithm is added to save operation time and improve the efficiency of the algorithm. The effectiveness of the improved algorithm is verified by comparative experiments and applied to the evaluation system so as to provide suggestions for the professional development of teachers from an objective perspective, and to build a harmonious, "people-oriented" evaluation system for students.

scholarly journals 683 Minimum Data Set in Documentation of Operative Findings in Diagnostic Laparoscopy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Nakhuda ◽  
A Liyanage ◽  
R Satchidanand
Keyword(s):  
General Medical Council ◽  
Second Phase ◽  
Medical Council ◽  
Data Set ◽  
Record Keeping ◽  
Operative Note ◽  
Quality Of Patient Care ◽  
Operative Findings ◽  
Operative Notes

Abstract Aim Legible, accurate and clear documentation of operative findings is an integral part of patient safety, with guidelines from the Royal College of Surgeons and General Medical Council having clear standards of operative note-keeping. However, a substantial variation in the quality and accuracy of these notes can still be observed in everyday practice. We recognised the significance of a minimum set of data in operative record keeping for diagnostic laparoscopies as a standard, to improve quality and uniformity. Method We retrospectively examined 50 diagnostic laparoscopies over 6 months and assessed their operative notes against the guidelines described above. We found that there was no clear uniformity in reporting, subjective descriptions used and a significant amount of under-reporting of operative findings. We developed a proforma as a substitute for the documentation of operative findings which was implemented in the second phase of the audit and the compliance was assessed over a 3-month period. Results We found that usage of the proforma was limited (9/22), however those notes using the proforma were compliant with the guidelines for operative note keeping, to a much higher degree than those without. All the operative findings were documented for 100% of those notes which used the proforma; for those using freehand notes, only the appendix was identified to the same standard, which is explained by all diagnostic laparoscopies proceeding to appendicectomies. Conclusions Using a proforma as standard record keeping can improve the quality and accuracy of operative notes and thereby help improve safety and quality of patient care.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

scholarly journals 179 Improving Operative Notes in Upper GI Surgery: An Innovative QI Project Utilising Existing Electronic Hospital Systems

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Sadik ◽  
A Butt ◽  
Z Gowie ◽  
J Carew ◽  
A Mehta ◽  
...  
Keyword(s):  
Electronic Records ◽  
Additional Information ◽  
Operative Care ◽  
Adequate Care ◽  
Hospital Systems ◽  
Operative Notes ◽  
Mean Compliance ◽  
Valuable Role ◽  
Electronic Hospital

Abstract Introduction Operative notes play a valuable role in ensuring that surgical patients receive consistent and adequate care. There are many inherent difficulties affecting their quality. We performed a QI project to improve surgical operative notes at our centre. Method A questionnaire assessing subjective quality of operative notes was sent to all foundation doctors delivering post-operative care. Compliance to each inclusion recommendation in the RCS guidelines was analysed. A standardised template for operative notes was incorporated into the hospital’s electronic records system, compliance was then reassessed. Results Questionnaire responses (16) were better for typed vs hand-written notes in all domains: ease of accessing notes, following intra-operative steps, following post-operative plans and frequency of asking for additional information regarding plans. After implementation of the template, mean compliance across 19 RCS parameters improved from 69% (55 operations) to 89% (46 operations). Number of parameters with 100% compliance improved from 2/19 to 8/19. Compliance increased in 14/19 parameters, there was no change in 2/19 (already 100%) and a reduction was seen in 3/19. Conclusions Results from our analysis and questionnaire showed that typed notes were favourable when compared to hand-written. The introduction of a standardised electronic template, without investment in new software, improved compliance to RCS guidelines.

The study of Iranian children and adolescents’ physical activity: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Adel Alizadeh ◽  
Reza Negarandeh ◽  
Fahimehe Bagheri Amiri ◽  
Zahra Yazdani
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
World Health ◽  
Chi Square ◽  
The Status ◽  
Newcastle Ottawa Scale ◽  
Health Organization ◽  
Iranian Children

Abstract Objectives This systematic and meta-analysis review was conducted to determine the status of Iranian children and adolescents’ physical activity. Content All the related articles which were published in the major databases, including Pubmed, Scopus, Web of Science, Embase, Magiran, SID from the beginning of 2010 to the end of 2019, were reviewed by researchers. The Newcastle-Ottawa scale was also used to evaluate the quality of articles. Moreover, I 2 index and chi-square were used to assess the heterogeneity between the results. Summary 490 articles were found as a result of the search in the selected international and local databases, where finally, 10 articles were included into the meta-analysis after the elimination of the duplicated articles and applying inclusion and exclusion criteria. The results indicated that 29.5% of the girls were considered active according to WHO criteria (16.1–42.8: 95% CI) and also 20.5% of the boys (7.3–33.7: 95% CI). Outlook Overall, this study’s findings showed that a large percentage of Iranian children and adolescents do not achieve the level of physical activity recommended by the World Health Organization. This can lead to undesirable consequences for this group of population that is considered as the human capital of any country; consequently, it seems necessary to take basic measures at the micro and macro levels in order to reduce such problems in the society.

scholarly journals Comparing quality of life between patients undergoing trans-areola endoscopic thyroid surgery and trans-oral endoscopic thyroid surgery

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuang Shen ◽  
Xiaochi Hu ◽  
Rui Qu ◽  
Youming Guo ◽  
Libo Luo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Surgery ◽  
Short Form ◽  
Endoscopic Thyroidectomy ◽  
Operation Time ◽  
Endoscopic Thyroid Surgery ◽  
Sf 36 ◽  
Areola Approach ◽  
High Level

Abstract Background Compared with conventional open surgery, endoscopic thyroidectomy via the oral vestibular approach (ETVOA) and endoscopic thyroidectomy via the areola approach (ETAA) avoided scarring of the skin, which may help patients achieve a better quality of life (QOL). However, the benefit of the QOL from this technique has not been adequately investigated, therefore this study compared the QOL outcomes between ETVOA and ETAA. Methods 131 patients were enrolled in this study. ETAA surgery and ETVOA surgery were performed in 74 patients and 57 patients, respectively. These patients were followed up at 2 weeks, 4 weeks, and 8 weeks, and their QOL was evaluated using a thyroid surgery-specific questionnaire and a short-form health survey (SF-36). Results There were no differences in clinical characteristics such as gender, age, body mass index (BMI), and tumor size between the two groups. The volume of intraoperative blood loss, cost of hospitalization, and complications between the two procedures showed no differences. Compared with ETAA, ETVOA has a longer operation time, no drainage, and shorter hospital stay. In the QOL questionnaire, several parameters in ETVOA were better. The satisfaction scores of patients undergoing ETVOA were higher. In addition, the cosmetic satisfaction in patients who received ETOVA was significantly better than that of patients who underwent ETAA. The degree of neck movement disorder in patients with ETVOA was milder. Patients who received ETVOA had higher score on the SF-36. Conclusions The trans-oral endoscopic approach can acquire better cosmetic results and achieved high-level QOL.

Answers and Questions: Evans-Pritchard On Nuer Religion

1983 ◽  
Vol 14 (3) ◽  
pp. 167-186 ◽  
Author(s):  
John W. Burton
Keyword(s):  
Catholic Church ◽  
Logical Consistency ◽  
Anthropological Study ◽  
The Status ◽  
The Many ◽  
The Catholic Church

AbstractIf my discernment of the thought that underlies his study of Nuer religion is not entirely misconstrued, then one can assert a logical consistency between Collingwood's methodology for history and Evans-Pritchard's for ethnography. It is worthwhile, in that light, to consider the fact that "at one time Evans-Pritchard contemplated writing Collingwood's biography" (Beidelman 1974:559). One commentator, (Kuper 1980:118) typifies this methodology as "postwar idealism" and suggests that the major works he published in the later decades of his presence at Oxford demonstrate the "sterility" of his methodology and theory. Still others have hinted that his entry into the Catholic Church was later reflected in his depiction of Nuer religous life. These are remarkable assertions, when one takes the time to reflect on the many ways in which his own approach and writings have so profoundly influenced the direction of anthropological enquiry in his own country and abroad. The fact is, one can no longer write ethnography in lieu of a solid understanding of the historical circumstances which have resulted in the contemporary 'ethnographic present'. At the same time, practitioners of the discipline have addressed from almost every angle the proposition that all ethnography is indeed a good part confession-that we write what we are able to see. That is precisely the quality of the work that will guarantee the status of Nuer religion as a classic. The methods of history and anthropology can only become more similar. Anyone who holds an absence of definition or presumed repugnance toward theory as criticisms of his contributions, has truly lost the forest for the trees. It is all the more remarkable that his methodological and theoretical advances in the anthropological study of religion are to be found not in his answers, but in the questions he raised.10

Regulating Proxy Advisors Through Transparency: Pros and Cons of the EU Approach

2017 ◽  
Vol 14 (1) ◽  
pp. 1-36 ◽  
Author(s):  
Gaia Balp
Keyword(s):  
Status Quo ◽  
Legislative Process ◽  
European Regulation ◽  
The Us ◽  
The Status ◽  
Pros And Cons ◽  
Proxy Advisors ◽  
Legal Constraints ◽  
The Eu

This article outlines potential pros and cons of a future European regulation of proxy advisory firms, as set forth in the Commission’s Proposal for a Directive amending Directive 2007/36/EC. After summarizing criticisms concerning the proxy advisory industry, and findings regarding its de facto influence on investors’ voting conduct both in the US and in the European context, the article adverts to why the power of proxy advisors appears to be overestimated. Uncertainty on the status quo of the industry’s actual impact on key decisions in listed companies, as well as costs associated with a regulation, need to be considered for assessing the suitability of the rules drafted to ensure adequate levels of independence and quality of voting recommendations. While transparency rules may be preferred to stricter legal constraints or requirements in a first stage, possible shortcomings of the Draft Directive exist that may undermine its effectiveness. Analyzing the amendments to the Proposal adopted by the European Parliament, and the Council’s Presidency compromise text, may suggest a preferable approach as regards single rules still making their way through the European legislative process.

scholarly journals Improving nursing documentation for surgical patients in a referral hospital in Freetown, Sierra Leone: protocol for assessing feasibility of a pilot multifaceted quality improvement hybrid type project

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nataliya Brima ◽  
Nick Sevdalis ◽  
K. Daoh ◽  
B. Deen ◽  
T. B. Kamara ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Sierra Leone ◽  
Referral Hospital ◽  
Audit And Feedback ◽  
Health System Strengthening ◽  
Theory Of Change ◽  
Improve Quality ◽  
Nursing Documentation

Abstract Background There is an urgent need to improve quality of care to reduce avoidable mortality and morbidity from surgical diseases in low- and middle-income countries. Currently, there is a lack of knowledge about how evidence-based health system strengthening interventions can be implemented effectively to improve quality of care in these settings. To address this gap, we have developed a multifaceted quality improvement intervention to improve nursing documentation in a low-income country hospital setting. The aim of this pilot project is to test the intervention within the surgical department of a national referral hospital in Freetown, Sierra Leone. Methods This project was co-developed and co-designed by in-country stakeholders and UK-based researchers, after a multiple-methodology assessment of needs (qualitative, quantitative), guided by a participatory ‘Theory of Change’ process. It has a mixed-method, quasi-experimental evaluation design underpinned by implementation and improvement science theoretical approaches. It consists of three distinct phases—(1) pre-implementation(project set up and review of hospital relevant policies and forms), (2) intervention implementation (awareness drive, training package, audit and feedback), and (3) evaluation of (a) the feasibility of delivering the intervention and capturing implementation and process outcomes, (b) the impact of implementation strategies on the adoption, integration, and uptake of the intervention using implementation outcomes, (c) the intervention’s effectiveness For improving nursing in this pilot setting. Discussion We seek to test whether it is possible to deliver and assess a set of theory-driven interventions to improve the quality of nursing documentation using quality improvement and implementation science methods and frameworks in a single facility in Sierra Leone. The results of this study will inform the design of a large-scale effectiveness-implementation study for improving nursing documentation practices for patients throughout hospitals in Sierra Leone. Trial registration Protocol version number 6, date: 24.12.2020, recruitment is planned to begin: January 2021, recruitment will be completed: December 2021.

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