Clinical Audit Improves Hypertension Control in Hemodialysis Patients

Esposito, Pasquale; Benedetto, Attilio Di; Tinelli, Carmine; Silvestri, Annalisa De; Rampino, Teresa; Marcelli, Daniele; Canton, Antonio Dal

doi:10.5301/ijao.5000202

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…Champions are those healthcare professionals who are committed to implementing change, act as a role model for the intended change and are enthusiastic in convincing others in the organisation of the necessity of change [69,82,86,89,101,103,109]. Two kinds of champions were identified, those that initiated an audit [36,49,54,59,69,74,82,89] and those nominated by the leadership of an organisation and given responsibility for carrying the audit forward [43,47,53,57,85,86,90,91,95,101,103,104,109,119]. In successful audits champions challenge, educate and lead their colleagues to improve the quality of care [69,90,91,95,101,119].…”

Section: Plos Onementioning

confidence: 99%

“…Furthermore, healthcare professionals consider an audit more relevant if one of their peers is the driving force, and this fosters trust [36]. This encouraged a more critical attitude and attention to the quality of the care they delivered, increases their commitment to QI [36,69,82,89], and lead to changes intended to improve care being successfully implemented [36,53,57,59]. A supportive organisational culture is an important contextual factor for champions to be able to perform [36,54,69,86,89,90,103].…”

Section: Plos Onementioning

confidence: 99%

“…In bottom-up initiated audits, healthcare professionals take the lead. These healthcare professionals work closely together to define appropriate improvements for their own local situation, and this ownership helps developing informal social ties and ensuring the acceptance of sustainable improvements in practice [53,57,59,60,80,91]. For example, during an audit about medication registration errors, nursing teams were empowered to develop their own strategies to improve practice [91].…”

Section: Plos Onementioning

confidence: 99%

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Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

et al. 2021

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Background Several types of audits have been used to promote quality improvement (QI) in hospital care. However, in-depth studies into the mechanisms responsible for the effectiveness of audits in a given context is scarce. We sought to understand the mechanisms and contextual factors that determine why audits might, or might not, lead to improved quality of hospital care. Methods A realist review was conducted to systematically search and synthesise the literature on audits. Data from individual papers were synthesised by coding, iteratively testing and supplementing initial programme theories, and refining these theories into a set of context–mechanism–outcome configurations (CMOcs). Results From our synthesis of 85 papers, seven CMOcs were identified that explain how audits work: (1) externally initiated audits create QI awareness although their impact on improvement diminishes over time; (2) a sense of urgency felt by healthcare professionals triggers engagement with an audit; (3) champions are vital for an audit to be perceived by healthcare professionals as worth the effort; (4) bottom-up initiated audits are more likely to bring about sustained change; (5) knowledge-sharing within externally mandated audits triggers participation by healthcare professionals; (6) audit data support healthcare professionals in raising issues in their dialogues with those in leadership positions; and (7) audits legitimise the provision of feedback to colleagues, which flattens the perceived hierarchy and encourages constructive collaboration. Conclusions This realist review has identified seven CMOcs that should be taken into account when seeking to optimise the design and usage of audits. These CMOcs can provide policy makers and practice leaders with an adequate conceptual grounding to design contextually sensitive audits in diverse settings and advance the audit research agenda for various contexts. PROSPERO registration CRD42016039882.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

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Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

et al. 2021

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“…According to the literature, many factors influence the manner of treatment and outcome, such as the quality of the transmission of information between the physician and patient [44,45,46]. Age, sex and socioeconomic circumstances also have an impact [47], as well as the number of patients under a physician's care [48].…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure of Maintenance Hemodialysis Patients in the Dalmatian Region of Croatia: Differences between Hospital and Out-of-Hospital Dialysis Centers

Gulin

Klarić²,

Ilić³

et al. 2017

Blood Purif

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Aims: This study was aimed at comparing the incidence of arterial hypertension and blood pressure (BP) variance in hospital and out-of-hospital hemodialysis (HD) patients during HD sessions. Methods: A cross-sectional study was conducted for 1 week at all the HD centers in Dalmatia, Croatia. The pre-, intra-, and post-dialysis BP values were collected for 3 consecutive HD sessions per patient. Results: Of the 399 subjects, 73.9% were hypertensives, who showed higher interdialytic weight gain compared to the normotensives (2.58 vs. 2.40). Hospital and out-of-hospital HD patients received identical antihypertensive therapies, except that beta blockers were more frequently administered to out-of-hospital HD patients. Higher pre-, intra-, and post-dialysis BP values were recorded in patients at out-of-hospital HD centers. Conclusion: The differences in BP variability and antihypertensive therapies administered to hospital HD patients as compared to out-of-hospital HD patients may reflect differing approaches by the nephrologists at these centers.

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“…Описан опыт успешного применения аудитов с целью анализа соблюдения критериев лечения кожных болез-ней у детей, обострений хронической обструктивной болезни легких, назначения аппендэктомии, соблюде-ния необходимых норм выполнения стоматологических процедур, надлежащего контроля за уровнем артериаль-ного давления [31][32][33][34][35][36][37][38][39][40].…”

Section: терминологияunclassified

Audit of the quality of medical care as a way to improve the efficiency of medical organizations

et al. 2017

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The article analyzes the possibilities of auditing the quality of medical care to improve the efficiency of medical organizations. The audit of the medical organization is a closed cycle to improve the quality of medical care, which should include assessing the actual assistance provided in relation toОднако в настоящее время в педиатрической систе-ме обнаруживается ряд проблем, связанных с недоста-точным знанием медицинским персоналом современных способов диагностики и лечения, актуальных классифи-каций, клинических рекомендаций, а также с плохим материальным обеспечением, в том числе выявляются дефекты управления и организации [2, 3]. Эти факторы существенно снижают качество оказываемой медицин-ской помощи, особенно в педиатрических стационарах.

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Clinical Audit Improves Hypertension Control in Hemodialysis Patients

Abstract: A clinical audit is an effective tool to improve BP control in HD patients.

Cited by 8 publications

References 30 publications

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

Blood Pressure of Maintenance Hemodialysis Patients in the Dalmatian Region of Croatia: Differences between Hospital and Out-of-Hospital Dialysis Centers

Audit of the quality of medical care as a way to improve the efficiency of medical organizations

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