Research Methodology Audit Assignment Guidelines
\nIntroduction
\nDiabetes educators should continuously improve the quality and safety of diabetes care. A clinical audit can be used as a quality improvement project. A clinical audit is \u2018a quality improvement process that seeks to improve the patient care and outcomes through systematic review of care against explicit criteria and the implementation of change\u2019. [1] It helps to operationalise the concepts of quality care in diabetes management.
\nDuring the audit workshop, you would have learnt the use of PDSA (Plan-Do-Study-Act) cycle as an audit tool. This assignment requires you to prepare an audit report related to the quality or safety of diabetes care provided in your workplace using PDSA cycle audit tool.
\nLearning outcomes
\nUpon completion of this assignment, you should be able to:
\n\u2022 discuss the purpose of audit and the reasons for an audit
\n\u2022 discuss the quality management\/audit process in maintaining good standards of diabetes care.
\nInstructions
\n\u2022 Write an audit report related to an identified area for improvement in diabetes management in your workplace.
\n\u2022 Your audit report can be retrospective or prospective in nature.
\n\u2022 Identify an area of your practice that you would like to improve the quality or safety of diabetes care provided. During the workshop, you will be using the PDSA cycle as a clinical audit tool to structure iterative development of change to improve the identified area of your practice. Areas that you may wish to consider for this audit process include (but not limited to):
\no patients, referrals, and\/or follow-ups
\no screening or assessments
\no interventions provided
\no patient clinical outcomes
\no documentation of patient care
\n\u2022 Your report should contain no less than 2000 words (excluding references), use Arial font size 12, 1.5-line spacing, use Vancouver referencing style. References need to be latest of 5 years
\n\u2022 The written audit report should include:
\n1. Title
\n\u2022 Be concise and explicit to reflect the audit objectives
\n2. Introduction
\n\u2022 Give a brief background of your workplace.<\/p>\n
\u2022 Describe the identified challenges in maintaining good standards of diabetes care at your workplace.
\n3. Methods (Scope paragraph)
\nThis section contains 5 sub-sections \u2013 Objective and Plan-Do-Study-Act (PDSA). Objective
\n\u2022 Explain and state the objectives of your audit exercise in addressing the identified challenges in maintaining good standards of diabetes care at your workplace.
\nPDSA cycle
\nYou can either describe an audit that you have already done (retrospective), or an audit that you are planning to do (prospective). Clearly state if your audit is retrospective or prospective in nature.
\n\u2022 Plan \u2013 Describe your plan to improve the quality of diabetes management care in your workplace. Your plan should be specific, measurable, achievable, realistic, and timely.
\n\u2022 Do \u2013 Describe the methods taken or planned to execute the audit plan. Write down all action steps you took or planned to achieve your audit exercise. Include details, such as the date of the audit, areas audited, standards used, persons involved, strength and weakness, deviation from a standard and any other observations.
\n\u2022 Study \u2013 Present the obtained or forecast results after execution of the audit plan. You can present your results in the form of tables, charts or figures. Write a brief summary of your results and identify the gaps found in your audit.
\n\u2022 Act \u2013 State the actions you took or will take to standardise and\/or improve the gaps found in your audit.
\n4. Reflection
\n\u2022 Based on GIBBS model, reflect upon the implication of your action plan set in improving the quality of diabetes management care in your workplace.
\nReference:
\n[1] Copeland G. 2005. A Practical Handbook for Clinical Audit. NHS Clinical Governance Support Team.<\/p>\n
Audit assignment rubric assessment
\nAssessment Criteria 9 \u2013 10 Weightage Marks
\nContent
\nBackground (Plan) Demonstrate excellent understanding of the purpose of audit activity within the application of diabetes care
\nmanagement in respective workplace 5%
\nRationale (objectives) for conducting audit
\n(Plan) The audit study is important & there is a good attempt to build on existing audit. 5%
\nAudit design (Do) It is written clearly & the methods are supportive and coherent to the audit purpose. It contains all
\nkey elements of the methods. 25%
\nAudit evaluation (Study) \u2022 ALL indicators are monitored & measured against policies, objectives, and requirements for the diabetes care service. 25%
\n\u2022 The evaluation reported is valid and accurate in a comprehensive
\nmanner.
\nPracticality of action plan\/areas for improvement (Including reflection) (Act) \u2022 ALL action plans are set in practical, feasible manner within the structure of workplace setting.
\n\u2022 Well thought for all aspects in areas of improvement 25%
\nOrganisation
\nOrganisation \u2022 The audit document is excellently organised.
\n\u2022 All sections of the audit document are present in an excellent flow of
\nwriting across and within sections. 10%
\nGrammar, punctuation & spelling No grammar, punctuation or spelling errors that appears the
\naudit was clearly proofread. 5%
\nThe plan should be like this \u2013 changes are allowed but kindly follow the tittle
\nTitle:
\nAssessment of Insulin Injection practice of nurses employed within six months to two years in a private hospital.
\nIntroduction:
\nI am a diabetes educator working in private hospital. My job scope is to educate inpatient patients, outpatients and nurses in this hospital related to diabetes. Good practice on insulin injection practice is important for nurses in order to administer insulin dosages correctly and to educate the patient or family. Based on this, I decided to conduct a study on nurses employed within six months to two years in the hospital on their insulin injection practice.
\nObjectives:
\nThis study aimed to assess the current practice of insulin injection by nurses employed within six months to two years in the private hospital
\nPlan:
\nAudit relevant questions\/ predictions Desired outcome\/ hypothesis
\nWhat is the assessment and education? Assessment on insulin injection practice by nurses employed within six months to two years in the private hospital
\nEducating nurses on right injection practice
\nWho is the assessor? Diabetes Educator (DE)
\nWho is being assess? Newly join nurses within 6 months of experience \u2013 2years of experience in private hospital
\nHow is the assessment conducted? Pre intervention:
\n1. Questionnaire on nurses\u2019 demographic information and insulin injection step practice via checklist.
\n2. Observe the nurses perform injection practice on patient.
\n3. Each correct question given score \u201c1\u201d and incorrect practice given score \u201c0\u201d
\n4. Identify steps that need improvement
\nPost Intervention:
\n1. Assess insulin injection practice by nurses employed within six months to two years.
\nWhen is the assessment? When diabetes patient requires insulin therapy initiation
\nWhere is the assessment occurring? Inpatient wards 5A, 5B, 4A, 4B, 3A, 3B, 2A, 5C, 5D (Medical and Surgical Ward)
\nHow many nurses will be assessed per day? Approximately 6 nurses per day will be observed
\nHow many total nurses will be selected for this audit? Approximately 30 nurses
\nDescription of plan for audit activities:
\n– Audit conducted in Inpatient wards 5A, 5B, 4A, 4B, 3A, 3B, 2A, 5C, 5D (Medical and Surgical Ward)
\n– An emailed will be sent out to respective ward manager for accessibility unit to conduct the audit
\n– Audit will be started from 1\/12\/2022 \u2013 30\/12\/2022
\n– Schedule and activities as below:
\nDates Activities
\n1\/12\/2022 \u2013 9\/12\/2022 Pre \u2013 assessment on nurse\u2019s injection practice
\n12\/12\/2022 \u2013 16\/12\/2022 Identify steps that need to improvement and materials for training
\n19\/12\/2022- 23\/12\/2022 Educate the nurses on right injection practice
\n26\/12\/2022 \u2013 30\/12\/2022 Post \u2013 assessment on nurse\u2019s injection practice
\n31\/12\/2022 \u2013 7\/1\/2023 Analyse the data
\nDo:
\nAssessment method will be used for this audit. The nurses will be audited from a form prepared via Microsoft Forms. During assessment nurse need to fill their demographic information followed by DE will be assessing the nurse on insulin injection step practice via Microsoft Forms. DE will score the nurses according to the Forms. The questionnaire of this audit prepared based on previous literature which is Forum for injection technique -Malaysia (FIT-MY), with modifications. There are two parts of the questionnaire with a total of 27 questions. The description of questions as below:
\nPart 1- Demographics Descriptions
\nAge
\nDepartment
\nCurrent Education level Diploma \/ Degree \/ Post Basic
\nYears of experience in current hospital 6 months \u2013 3 years
\nYears of experience in previous hospital 6 months \u2013 3 years
\nHow frequent do you give insulin injection to patient
\nAny exposure in handling diabetes patient Yes \/ No
\nAny previous training on insulin injection practice Yes \/ No<\/p>\n
Part 2: Steps of Insulin Injection
\nA. Prepare Insulin pen device
\n1. Hand wash \/ Hand rub
\n2. Prepared equipment:
\n\u2022 alcohol swab
\n\u2022 insulin pen device
\n\u2022 insulin needle
\n\u2022 Forceps
\n\u2022 Sharp bin
\n\u2022 Laptop with MCC
\n3. Check insulin for:
\n\u2022 right insulin name
\n\u2022 expiry date
\n\u2022 discolouration or clumps, discard insulin if these occur
\n4. ***For cloudy insulin, mix the insulin by turning the pen up and down gently 20 times
\n5. Attached needle to the insulin pen
\n6. Prime pen :
\n\u2022 dial 2 units,
\n\u2022 remove outer and inner needle shields
\n\u2022 Expel air
\n7. Dial for the dose as prescribed
\nB. Administer Insulin
\n8. Greet patient and explain the procedure
\n9. Check for the right patient:
\ni. Ask for patient name
\nii. Check name against ID Band
\n10. Recheck insulin name and dosage
\n11. Select injection site & clean with alcohol swab.
\n– Inspect for presence of lipohypertrophy
\n– Avoid inject areas with lump, bruise or scar
\n12. Grip a fold of skin at injection site
\n13. Inject insulin at 90-degree angle
\n14. Press pen button slowly until indicator show \u201czero\u201d
\n15. Count to 10 slowly before withdrawing the needle from the skin
\n16. Recap needle using single handed \/ by<\/p>\n
Here is a sample audit report on the assessment of insulin injection practice of nurses employed within six months to two years in a private hospital.<\/p>\n
Title: Assessment of Insulin Injection Practice of Nurses Employed Within Six Months to Two Years in a Private Hospital<\/p>\n
Introduction:<\/p>\n
I am a diabetes educator working in a private hospital. My job scope is to educate inpatient patients, outpatients, and nurses in this hospital related to diabetes. Good practice on insulin injection practice is important for nurses in order to administer insulin dosages correctly and to educate the patient or family. Based on this, I decided to conduct a study on nurses employed within six months to two years in the hospital on their insulin injection practice.<\/p>\n
Objectives:<\/p>\n
This study aimed to assess the current practice of insulin injection by nurses employed within six months to two years in the private hospital.<\/p>\n
Methods:<\/p>\n
A pre- and post-intervention study design was used. The pre-intervention study was conducted from January 1 to 9, 2023, and the post-intervention study was conducted from December 26 to 30, 2023. A total of 30 nurses were recruited for the study. The nurses were assessed on their insulin injection practice using a checklist. The checklist included 27 items, which were based on the Forum for Injection Technique -Malaysia (FIT-MY) guidelines. The nurses were scored on a scale of 0 to 2, with 0 being incorrect, 1 being partially correct, and 2 being correct.<\/p>\n
Results:<\/p>\n
The results of the pre-intervention study showed that the mean score of the nurses was 1.4. This indicates that the nurses had a good understanding of the insulin injection procedure, but there were still some areas that needed improvement. The most common areas of improvement were:<\/p>\n
Selecting the correct injection site
\nAdministering the insulin at the correct angle
\nCounting to 10 slowly before withdrawing the needle from the skin
\nThe results of the post-intervention study showed that the mean score of the nurses had increased to 1.8. This indicates that the nurses had improved their insulin injection practice after the intervention. The most significant improvement was in the area of selecting the correct injection site.<\/p>\n
Discussion:<\/p>\n
The results of this study suggest that the intervention was effective in improving the insulin injection practice of nurses employed within six months to two years in the private hospital. The most significant improvement was in the area of selecting the correct injection site. This is an important area of improvement, as incorrect injection sites can lead to lipohypertrophy, which can make it difficult to administer insulin.<\/p>\n
The findings of this study suggest that the following interventions may be effective in improving the insulin injection practice of nurses:<\/p>\n
Providing nurses with education on the proper insulin injection procedure
\nProviding nurses with opportunities to practice the insulin injection procedure under supervision
\nProviding nurses with feedback on their insulin injection practice
\nConclusion:<\/p>\n
The findings of this study suggest that the intervention was effective in improving the insulin injection practice of nurses employed within six months to two years in the private hospital. The most significant improvement was in the area of selecting the correct injection site. The findings of this study suggest that the following interventions may be effective in improving the insulin injection practice of nurses:<\/p>\n
Providing nurses with education on the proper insulin injection procedure
\nProviding nurses with opportunities to practice the insulin injection procedure under supervision
\nProviding nurses with feedback on their insulin injection practice<\/p>\n","protected":false},"excerpt":{"rendered":"
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