Clinical audit and the implementation of the Ottawa Ankle Rules

Emerald - Tập 10 Số 1 - Trang 59-61 - 2005
V.Jennings1, C.Newton1, K.Bonner1, R.Hancock1
1Burton Hospitals NHS Trust, Burton‐on‐Trent, UK

Tóm tắt

PurposeTo implement the research‐based Ottawa Ankle Rules in a district hospital and audit their impact on the number and appropriateness of X‐rays for ankle injuries in A&E.Design/methodology/approachThe method used was retrospective data collection, followed by education and prospective data collection on the management of subsequent ankle injuries. The computer records of the first 150 people presenting to A&E with ankle/foot injuries in one month were reviewed to determine whether the patient underwent an X‐ray, and what the results were. Every doctor working in A&E was then educated using a hand‐out giving the Ottawa Ankle Rules. The management of 150 people presenting with ankle/foot injuries in the month after this intervention was assessed.FindingsThere was a reduction in the number of patients receiving X‐rays (83/150 or 55 per cent versus 128/150 or 85 per cent pre‐intervention; p<<0.001). There was also an increase in the proportion of X‐rays showing fractures (17/83 or 20 per cent versus 16/128 or 12.5 per cent; difference not statistically significant).Research limitations/implicationsPossible to stimulate good practice with audit.Practical implicationsImprovement in practice stimulated by a motivated trainee doctor with appropriate support. Factors contributing to success discussed.Originality/valueEncouraging example of successful audit, of interest to those interested in using clinical audit to improve care.

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Tài liệu tham khảo

Bachmann, L.M., Kolb, E., Koller, M.T., Steurer, J. and ter Riet, G. (2003), “Accuracy of Ottawa Ankle Rules to exclude fractures of the ankle and midfoot: systematic review”, British Medical Journal, Vol. 326, pp. 417‐23.

Hancock, R.J.T., Oddy, M., Saweirs, W.M. and Court, B. (1997), “The RCP stroke audit package in practice”, Journal of the Royal College of Physicians of London, Vol. 31, pp. 74‐8.

Stiell, I.G., McKnight, R.D., Greenberg, G.H., McDowell, I., Nair, R.C., Wells, G.A., Johns, C. and Worthington, J.R. (1994), “Implementation of the Ottawa Ankle Rules”, Journal of the American Medical Association, Vol. 271, pp. 827‐32.

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Emerald

Tập 10 Số 1

59-61

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