Audit and research

Assessing the Feasibility of Retrospective and Prospective Clinical Audit in Farm Animal Veterinary Practice

As a quality improvement tool, clinical audit has been extensively described in the medical literature. There is scant literature on the use of clinical audit in the farm animal veterinary setting. This study describes the process and feasibility of prospective and retrospective data collection for farm animal clinical audit performed at three different farm animal practices in the United Kingdom. Retrospective clinical audit was difficult in all three practices due to barriers in establishing diagnosis and patient identity from clinical records. Prospective data collection proved feasible but depended on adequate case accrual and practitioner engagement. The decision to conduct clinical audit retrospectively or prospectively will depend on the topic to audit, the availability of data and the wishes of the team members involved. Further work is required looking at the use of clinical coding and alternatives to using practice management software to improve retrospective data availability for clinical audit.

Pulse oximetry knowledge and its effects on clinical practice

AIM

to explore literature pertaining to registered nurses' and/or doctors' knowledge in relation to the pulse oximetry in clinical practice.

BACKGROUND

pulse oximeters provide non-invasive readings of both pulse rate and peripheral oxygen saturation, leading to quick identification of potential/actual problems. Because of this, clinicians, like nurses, may become too dependent on it, neglecting other aspects of the holistic assessment process.

METHODS

a literature search was carried out between 1980 and 2006, with much of the data skewed towards 1994-2006. As the central focus was to be on pulse oximetry knowledge of nurses and/or doctors, articles included had to contain a central theme addressing this. Other criteria for inclusion were links between pulse oximetry and knowledge in clinical practice, nurses and/or doctors as participants in studies addressing this, as well as the clinical competency in relation to the device.

CONCLUSION

improving knowledge may not necessarily be the answer in improving clinical competency. Future research will need to be carried out to measure the connection between knowledge and competency and to use that as a basis for education and training.

Talking on the telephone with people who have experienced pain in hospital: clinical audit or research?

The adequacy of postoperative pain management in British hospitals appears insufficient to improve patient care, and much of the research and clinical audit in postoperative pain has failed to seek the patient's perspective. This paper reports on the findings from a semi-structured telephone interview survey which formed part of a hospital-wide audit on postoperative pain at a district general hospital in the south of England. Of a total of 360 completed audit questionnaires, 114 patients left their telephone number and 29 were interviewed. Content analysis revealed five main themes: inadequate information, pain at home, staff attitudes, expectations of pain, and ward atmosphere. Several patients identified insightful strategies that potentially could improve pain management. The telephone interview generated a richness of data that had not been reported before in this important area. Some authors view clinical audit and research as having different characteristics but this work raises important questions for both approaches when using the semi-structured telephone interview. The ethical issues pertaining to collection of audit data using the telephone interview are discussed.