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Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit

BACKGROUND: The audit-feedback cycle is a behaviour change intervention used to reduce evidence-practice gaps. In this study, repeat audits, feedback, education and training were used to change practice and increase compliance with Australian guideline recommendations for stroke rehabilitation. OBJE...

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Autores principales: Vratsistas-Curto, Angela, McCluskey, Annie, Schurr, Karl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5699124/
https://www.ncbi.nlm.nih.gov/pubmed/29450304
http://dx.doi.org/10.1136/bmjoq-2017-000212
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author Vratsistas-Curto, Angela
McCluskey, Annie
Schurr, Karl
author_facet Vratsistas-Curto, Angela
McCluskey, Annie
Schurr, Karl
author_sort Vratsistas-Curto, Angela
collection PubMed
description BACKGROUND: The audit-feedback cycle is a behaviour change intervention used to reduce evidence-practice gaps. In this study, repeat audits, feedback, education and training were used to change practice and increase compliance with Australian guideline recommendations for stroke rehabilitation. OBJECTIVE: To increase the proportion of patients with stroke receiving best practice screening, assessment and treatment. METHODS: A before-and-after study design was used. Data were collected from medical records (n=15 files per audit). Four audits were conducted between 2009 and 2013. Consecutive files of patients with stroke admitted to the stroke unit were selected and audited retrospectively. Staff behaviour change interventions included four cycles of audit feedback, and education to assist staff with change. The primary outcome measure was the proportion of eligible patients receiving best practice against target behaviours, based on audit data. RESULTS: Between the first and fourth audit (2009 and 2013), 20 of the 27 areas targeted (74%) met or exceeded the minimum target of 10% change. Practice areas that showed the most change included sensation screening (+75%) and rehabilitation (+100%); neglect screening (+92%) and assessment (100%). Some target behaviours showed a drop in compliance such as anxiety and depression screening (−27%) or little or no overall improvement such as patient education about stroke (6% change). CONCLUSIONS: Audit feedback and education increased the proportion of inpatients with stroke receiving best practice rehabilitation in some, but not all practice areas. An ongoing process of quality improvement is needed to help sustain these improvements.
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spelling pubmed-56991242018-02-15 Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit Vratsistas-Curto, Angela McCluskey, Annie Schurr, Karl BMJ Open Qual Original Article BACKGROUND: The audit-feedback cycle is a behaviour change intervention used to reduce evidence-practice gaps. In this study, repeat audits, feedback, education and training were used to change practice and increase compliance with Australian guideline recommendations for stroke rehabilitation. OBJECTIVE: To increase the proportion of patients with stroke receiving best practice screening, assessment and treatment. METHODS: A before-and-after study design was used. Data were collected from medical records (n=15 files per audit). Four audits were conducted between 2009 and 2013. Consecutive files of patients with stroke admitted to the stroke unit were selected and audited retrospectively. Staff behaviour change interventions included four cycles of audit feedback, and education to assist staff with change. The primary outcome measure was the proportion of eligible patients receiving best practice against target behaviours, based on audit data. RESULTS: Between the first and fourth audit (2009 and 2013), 20 of the 27 areas targeted (74%) met or exceeded the minimum target of 10% change. Practice areas that showed the most change included sensation screening (+75%) and rehabilitation (+100%); neglect screening (+92%) and assessment (100%). Some target behaviours showed a drop in compliance such as anxiety and depression screening (−27%) or little or no overall improvement such as patient education about stroke (6% change). CONCLUSIONS: Audit feedback and education increased the proportion of inpatients with stroke receiving best practice rehabilitation in some, but not all practice areas. An ongoing process of quality improvement is needed to help sustain these improvements. BMJ Publishing Group 2017-11-06 /pmc/articles/PMC5699124/ /pubmed/29450304 http://dx.doi.org/10.1136/bmjoq-2017-000212 Text en © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Original Article
Vratsistas-Curto, Angela
McCluskey, Annie
Schurr, Karl
Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit
title Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit
title_full Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit
title_fullStr Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit
title_full_unstemmed Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit
title_short Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit
title_sort use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5699124/
https://www.ncbi.nlm.nih.gov/pubmed/29450304
http://dx.doi.org/10.1136/bmjoq-2017-000212
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