The Role of Clinical Audits in Advancing Quality and Safety in Healthcare Services: A Multiproject Analysis From a Jordanian Hospital.

Introduction Clinical audits have become essential instruments for evaluating and improving the standard of patient care in healthcare services. While individual clinical audits focus on particular aspects of care, multiple clinical audits across various domains, specialties, or departments provide a more comprehensive understanding of clinical practice and encourage systemic improvements. Methodology This study employed a mixed-methods approach to review and assess various clinical audits and quality improvement initiatives conducted at Al-Karak Governmental Hospital in southern Jordan. The study aimed to identify obstacles and possibilities of conducting clinical audits and provide suggestions for enhancing audit procedures and results. Data were collected from both retrospective and prospective sources and analyzed using descriptive and inferential statistics. Results The study comprised 11 audits conducted in three medical departments, namely surgery, obstetrics and gynecology (OB/GYN), and pediatrics, with a total of 618 participants. The improvements in adherence to guidelines after the second loop of all the audits were significant and showed significant improvements in adherence to guidelines, demonstrating the efficacy of clinical audits in improving clinical practice and outcomes. Conclusions Clinical audits are essential for maintaining and improving quality and safety in healthcare services, particularly in developing nations where emergency obstetric care is lacking. Multiple clinical audits provide a comprehensive understanding of clinical practice and encourage systemic improvements. The findings of our study suggest that clinical audits can lead to significant improvements in adherence to guidelines and better clinical outcomes. Future research should focus on identifying best practices for conducting clinical audits and evaluating their long-term viability and expandability.

A Multicentric Audit to Reevaluate the Guidelines Adherence in Computed Tomography of Kidneys, Ureters, and Bladder (CT-KUB) X-ray Imaging in Jordan.

Background With the increasing use of imaging techniques involving ionizing radiation, the area of the body scanned should be restricted to what is required to answer the clinical question. Therefore, this is a retrospective audit that intends to evaluate the presence of overscanning in renal computed tomography (CT) scan images during the process of evaluation for urinary symptoms. Objective This study aims to reduce the unnecessary scan length and exposure to radiation in patients who undergo CT scans for urinary symptoms. Materials and Methods In two months duration, patients from different clinics underwent CT imaging, and the resulting radiographic images were collected and analyzed. Overscanning was defined to be more than 10% of the total scan. Subsequently, the total length of the CT scan was measured which is used to measure the unnecessary overscan above the highest kidney margin as a percentage of the total length. Results Out of the 88 patients who were evaluated, 100% did not meet the guidelines for renal CT imaging and were exposed to a high radiation dose. However, the minimum percentage of overscanned patients was 20-40%. Conclusion A significant number of scans demonstrated surplus overscanning above the highest kidney. Therefore, recognizing the suitable anatomical landmarks for scanning and establishing a follow-up audit are suggested measures to minimize the noxious effects of radiation exposure.

Infection Control in Hospitals of Jordan: Challenges and Opportunities.

It is essential to take measures to prevent healthcare-associated infections (HAIs) and antibiotic resistance (AR) in order to ensure the safety of patients, control infections, protect public health, and maintain the overall quality and sustainability of the healthcare systems. The implementation of complex infection control strategies, the judicious utilization of antibiotics, health education, and global collaboration are necessary in order to address these significant challenges in the healthcare sector. In Jordan's hospitals, infection control is a dynamic sector that is always adjusting to changing hazards and best practices due to the constant evolution of the profession. The nation's healthcare system strives to uphold high standards of hygiene and patient safety in order to achieve its goals of lowering the risk of infections that are linked with healthcare and protecting the general population's health. Hospitals in Jordan effectively manage infection control by using a multifaceted approach that includes regulation implementation, committees dedicated to the task, considerable training, and a variety of procedures. Patient, employee, and visitor safety are given first priority by these effective procedures. The careful application of personal protective equipment (PPE), strict isolation and quarantine procedures, well-defined visiting policies, pre-emptive vaccination campaigns, and thorough environmental cleaning procedures are essential elements of this strategy.

Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis and a Double Superior Vena Cava.

BACKGROUND Situs inversus totalis (SIT) is an uncommon condition characterized as a congenital disorder in which the visceral organs are inverted relative to their typical anatomical position. SIT with double superior vena cava (SVC) is an even rarer presentation. Due to the underlying anatomical difference, the diagnosis and treatment of gallbladder stones in patients with SIT are challenging. CASE REPORT We report the case of a 24-year-old male patient who presented with an intermittent history of epigastric pain for 2 weeks. Clinical assessment and radiological investigations confirmed gall bladder stones with evidence of SIT and double superior vena cava (SVC). The patient underwent elective laparoscopic cholecystectomy (LC) with an inverted laparoscopic approach. The recovery from the operation went smoothly, the patient was discharged from the hospital the following day, and the drain was removed on the third postoperative day. CONCLUSIONS Because anatomical variations in the SIT can affect localization of symptoms in patients with complicated gallbladder stones, the diagnosis of patients who have abdominal pain and SIT necessitates both a high index of suspicion and a thorough assessment. Although LC is considered to be a technically challenging surgery and calls for modification of the standard protocol, it is nevertheless feasible to perform the procedure effectively. To the best of our knowledge, this is the first time that LC has been documented in a patient who has SIT and double SVC.

An Audit to Reevaluate the Adherence to the Guidelines in Patients With Urinary Tract Infection at the Al-Karak Hospital in Jordan.

Background Urinary tract infection (UTI) is a common and costly health problem that affects millions of people worldwide. The proper management of UTI requires adherence to clinical guidelines that are based on the best available evidence. However, compliance with these guidelines in real-world practice is often suboptimal. Objective This study is aimed to audit and reevaluate the adherence to the guidelines in UTI patients at Al-Karak Hospital, Jordan. Methods A retrospective cohort study was conducted. The first loop included 50 patients who presented with symptoms of simple uncomplicated UTI and were treated at the clinic during a three-month period. The second loop included a reevaluation of the first loop's findings after implementing changes to the clinical practice based on the initial audit results. Results The main factors that influenced the adherence were the type of UTI, the presence of comorbidities, the duration of hospitalization, and the antibiotic choice. At the first loop, the audit findings identified that the 100% standard National Institute for Health and Care Excellence (NICE) guidelines met the reach of 20 (40%) of the 50 patients. A revaluation of the audit findings identified that the 100% standard NICE guidelines met the reach of 36 of the 50 (72%) patients. Conclusion The study concluded that there is a need to improve adherence to the guidelines in UTI patients at the Al-Karak Hospital and suggested some recommendations to achieve this goal.