Results Of Audit Research Articles

CONDUCTING AN INDUSTRIAL SAFETY AUDIT AT OIL AND GAS FACILITIES

In modern conditions, it has become necessary to partially shift responsibilities for supervision and control of industrial safety without deterioration of quality from the state to business. Large-scale oil and gas companies have a great demand for an independent assessment of industrial safety at hazardous production facilities, due to a significant increase in financial costs for eliminating the consequences of accidents at hazardous production facilities of I and II hazard classes. The state is interested in controlling a new type of activity and expanding the regulatory framework for industrial safety. President of the Russian Federation Vladimir V. Putin signed Federal Law No. 637-FZ dated December 25, 2023, which amends the Federal Law «On Industrial Safety of Hazardous Production Facilities» and some other legislative acts. One of the key innovations is the introduction of the Institute for Audit of Industrial Safety Management Systems. This article analyzes the best existing practices of conducting industrial safety audits in large-scale oil and gas companies of the Russian Federation. Particular emphasis was placed on identifying the advantages and positive aspects of implementing such activities in organizations like Rosneft, Gazprom and Lukoil. The issues of assessing the compliance of hazardous production facilities in the oil and gas complex with the requirements of legislation in the field of industrial safety by conducting an industrial safety audit were raised. The purpose of the work is to develop a step-by-step algorithm for conducting an industrial safety audit for oil and gas facilities. The industrial safety audit algorithm includes four steps: preparation for the audit, documentary analysis, full-scale audit, and registration of the results. The result of an industrial safety audit is an audit report drawn up at the final meeting of auditors and customers, based on documentary and in-kind inspections. This document is necessary for the management of the enterprise and the supervisory authorities of the Russian Federation. Industrial safety audit provides a number of significant advantages that help organizations to identify deviations from mandatory requirements established in the field of industrial safety. This makes it possible to detect violations in a timely manner and promptly take the necessary corrective measures to eliminate the identified problems. As a result, effective audit contributes to improving the overall safety level at enterprises, preventing possible risks and reducing the possibility of emergencies.

Investigating the Structural Model of Whistle Blowing System on Government Procurement Fraud: Examining Mediating Effect of Investigative Audit

This study aims to develop a fraud disclosure model in government procurement in Indonesia through a whistle blowing system with an investigative audit as a mediator. Disclosure of fraud is the result of an investigative audit. The effectiveness of the implementation of investigative audit procedures will be achieved if the auditor has the ability to carry out each stage in the audit standard. To maximize the performance of investigative audits, a system is needed to uncover fraud. The whistleblowing system is expected to be an effective tool to reveal fraud in government procurement. The research was conducted by distributing questionnaires to respondents electronically by sending a google form link containing a list of questions to auditors at the Supreme Audit Agency (BPK) and internal auditors at the Financial and Development Supervisory Agency (BPKP) throughout Indonesia. The results of the study found that the use of a whistle blowing system could increase the effectiveness of investigative audits on government procurement. Another finding is that investigative audits can reduce the disclosure of government procurement fraud. The effectiveness of the whistle blowing system in reducing the level of disclosure of government procurement fraud does not occur directly, but must be mediated by a good investigative audit. The results of this study indicate that the reporting of government procurement fraud cases on the whistle blowing system must be followed up with a thorough investigative audit so that disclosures of government procurement fraud cases can be traced better. Additional analysis in this study shows that although the functions of external auditors and internal auditors are different, the level and type of disclosure of government procurement fraud do not differ.

Promoting audit transparency in higher education through an internal academic quality audit application

This study aims to design and develop a web-based application for Internal Quality Audit at Universitas Ibnu Sina, replacing the conventional audit process which is currently in use. The previous manual audit process resulted in inefficiencies and increased the risk of errors. Key challenges identified include limitations in human resources, time, and funding, as well as the low effectiveness of the audit process. In order to address these issues, the proposed information system facilitates the distribution of online checklists and document uploads, thereby expediting the verification and reporting audit results. This research adopts the System Development Life Cycle (SDLC) approach in its development, utilizing methods that include use case diagrams, activity diagrams, sequence diagrams, and database design. These methods enhance interaction and workflow within the audit team. Testing results indicate that the system functions to the expected specifications. Furthermore, this study demonstrates that implementing a web-based system can accelerate reporting, improve the structure and documentation of audits, and support efforts to enhance academic quality at the university. Implementing this system is expected to increase efficiency and accuracy in the academic quality audit process at Universitas Ibnu Sina.

Improving the nursing quality of non-pharmacological interventions for elderly constipation patients in the hospital: a best practice implementation project.

Non-pharmacological interventions are the preferred treatment for constipation; however, health care professionals in clinical settings tend to focus more on pharmacological treatments. This best practice implementation project aimed to integrate the best evidence on non-pharmacological interventions for elderly patients with constipation in clinical care practice and to promote the use of non-pharmacological interventions for such patients in the hospital setting. This project is based on the JBI Evidence Implementation Framework, which follows three stages. The first stage involved a baseline audit using two audit criteria derived from the best available evidence. This audit evaluated current clinical scenarios, guided by the i-PARIHS framework. The second stage involved analyzing the results of the baseline audit, identifying barriers to compliance, and developing and implementing strategies to overcome those barriers. Strategies included nursing education, development of constipation information booklets for nurses and patients, establishment of a nursing workflow, and modification of the department environment. In the third stage, a follow-up audit was conducted to evaluate the implementation, using the same data collection indicators and methods as in the baseline audit. Sixty patients participated in the project. Compliance for Criterion 1 (patient education) increased from 0% to 60% (P < 0.001), while compliance for Criterion 2 (monitoring patients' bowel health) increased from 0% to 100% (p < 0.001). The results indicate that this evidence-based implementation project facilitated the application of non-pharmacological interventions for elderly patients with constipation. Nurses played a significant role in developing regular defecation habits in patients and monitoring their defecation. http://links.lww.com/IJEBH/A284.

Post-operative pain management in a surgical unit in a tertiary hospital in Spain: a best practice implementation project.

More than 80% of patients experience post-surgical pain. Poor pain control decreases patients' quality of life; increases associated comorbidity, hospital length of stay and hospital costs; and delays functional recovery. Implementing evidence-based recommendations improves these negative factors as well as the patient's quality of life. This evidence implementation project aimed to improve post-operative pain management by implementing best practice recommendations. This project used the JBI Evidence Implementation Framework, which is grounded in an audit and feedback process. The project was conducted in the surgical unit of a tertiary hospital in Ciudad Real, Spain. We performed a baseline audit and two follow-up audits to measure audit criteria derived from a JBI evidence summary on pain management. A total of 30 surgical patients took part. We assessed the results of the baseline audit, identified the barriers to best practice, and implemented strategies to improve post-operative pain management. The first follow-up audit revealed an improvement in practice; however, these results worsened due to the delay in protocol approval and subsequent lack of staff motivation. The second follow-up audit showed greater compliance with best practices, although considerable room for improvement remains. Implementing evidence-based practices in health care improved nurses' clinical practice. The health care staff complied with the recommendations more readily since they associated the best practices with a clear benefit for the patient. http://links.lww.com/IJEBH/A276.

Quality in Acute Stroke Care (QASC) Germany: improving efficiency in stroke care with nurse-initiated FeSS-protocols

BackgroundNurse-initiated supported implementation of protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following acute stroke reduced 90-day death and disability in the landmark Australian Quality in Acute Stroke Care (QASC)-Trial. An international interprofessional collaboration sought to evaluate the effects of nurse-led FeSS implementation on FeSS Protocol adherence in German stroke units.MethodsThis pre-test/post-test study was conducted in eight German stroke units between 2020 and 2022. Stroke nurses as clinical champions, supported by the project team, conducted multidisciplinary workshops discussing pre-implementation medical record audit results, barriers and facilitators to FeSS Protocol implementation, developed action plans and provided education, with ongoing support from Australia. Medical record audit data were collected by nurses, pre-implementation and three months post-implementation.ResultsIn 771 (pre-implementation) and 679 (post-implementation) patients there were improvements in overall FeSS adherence (pre 20%, post 28%; adjusted difference in proportions (95% CI) 11%, (5.1%, 16%); p < 0.001), adherence to hyperglycaemia (pre 43%, post 55%; adjusted difference 23%, (17%, 29%); p < 0.001) and swallowing (pre 52%, post 61%; adjusted difference 11%, (5.2%, 17%); p < 0.001) but not fever protocol (pre 76%, post 78%; adjusted difference 1.5%, (-2.6%, 5.7%); p = 0.474). Improvements also were noted in administration of anti-pyretics (pre 29%, post 59%; adjusted difference 32%, (20%, 44%); p < 0.001); and insulin (pre 41%, post 60%; adjusted difference 14%, (1.1%, 28%); p < 0.034) both within one hour, as well as in performing a swallow screen within 24 h of admission (pre 65%, post 74%; adjusted difference 18% (8.8%, 26%); p < 0.001).ConclusionsSupported implementation of the FeSS Protocols significantly improved acute care for post stroke complications of fever, hyperglycaemia and dysphagia in terms of higher adherence and shorter time to treatment.Trial registrationAs this is a pre-test/post-test study and does not meet the WHO/ICMJE definition of a clinical trial, registration was not required.

8192 A Two-Cycle Clinical Audit Testing Inpatient Management Of Hypophosphatemia In A UK District Hospital

Abstract Disclosure: J. Porto: None. E. Ssemmondo: None. N. Obike: None. A. Abobaker: None. R. March: None. N. Tun: None. T. Pawlak: None. Objective: A clinical audit was conducted to assess if there was any improvement in management of hypophosphatemia among patients admitted to the medical wards using the local Trust protocol, following structured edcational sessions to the junior doctors covering medical wards. Design and methodology: The 2 cycles of the audit were conducted between March 2020 and September 2021 in Scarborough district Hospital. The clinical notes of 52 patients (20 in the first cycle and 32 in the re-audit) with hypophosphatemia were reviewed. These were identified using the electronic laboratory results of patients within the study period. The aspects of the trust protocol for management of hypophosphatemia that were audited; documentation of symptoms associated with low phosphate levels, cardiac monitoring in severe hypophosphatemia, identification of the likely cause of hypophosphatemia, the presence or absence of associated acute kidney injury (AKI) and initiation of phosphate replacement. The results of the first audit were presented at the local hospital clinical governance meeting (August 2020). Following this, 2 teaching sessions and 2-case based discussion on hypophosphatemia were organised for all the doctors in the department of medicine. The re-audit was subsequently conducted after the fourth teaching session. The proportions of each audited item were compared between the first audit and the re-audit using Fisher exact probability test. Results:25% of patients in the first audit had severe hypophosphatemia compared to 28% in the re-audit. In patients with severe hypophosphataemia, only 33.3% had cardiac monitoring during the re-audit cycle compared to 60% in the first cycle, and the difference was not statistically significant (p=0.58). There was significant improvement in the documentation of symptoms of hypophosphataemia amongst inpatients during the re-audit cycle compared with the initial cycle; 62.5% vs only 10% (P 0.002). Most patients had an underlying cause of the hypophosphatemia identified (80% and 62.5%-first and second cycle respectively). AKI was associated with hypophosphataemia in 15% &amp; 34.4% (P 0.2) in the first and second cycles respectively. Despite low phosphate levels, 25% and 28.1% at the initial audit and the second cycle respectively did not receive any form of phosphate replacement. Conclusion: The two-cycle clinical audit showed that the teaching sessions on management of hypophosphatemia increased the awareness of the importance to document whether the patients were symptomatic or asymptomatic following the drop in their phosphate levels, which can help to identify patients at risk of developing complications, such as cardiac arrythmias. However, these sessions were not sufficient to improve overall management of patients with low phosphate levels. Presentation: 6/1/2024

Pengaruh Audit Tenure, Rotasi Audit, Dan Fee Audit Terhadap Kualitas Audit Pada Perusahaan Idx80 Yang Terdaftar Di Bursa Efek Indonesia Tahun 2021-2023

The incident of poor audit quality explains that the auditor is fully responsible for the entire audit process until the final audit results are obtained. This study aims to partially examine the effect of audit tenure, audit rotation and audit fees on audit quality. The data used is secondary data obtained from consolidated annual reports and audited financial reports in IDX80 companies for 2021-2023. The population in this study were IDX80 companies listed on the Indonesia Stock Exchange in 2021-2023 with purposive sampling technique for sampling so that 47 sample companies were obtained with 141 observed financial reports. The analysis technique used is binary logistic regression analysis with associative survey quantitative methods. The results obtained show that audit tenure and audit rotation partially have a positive but not significant effect on audit quality, while audit fees have a significant positive effect on audit quality. The contribution of this research is that audit quality measured using the organization and governance of Public Accounting Firms in accordance with the Decree of the Executive Board of the Indonesian Institute of Certified Public Accountants No. 4 of 2018 concerning Guidelines for Audit Quality Indicators at Public Accounting Firms.

PDOC-16 A RETROSPECTIVE AUDIT ON PRIMARY PEDIATRIC BRAIN TUMOURS TREATED AT DR GEORGE MUKHARI ACADEMIC HOSPITAL, GA-RANKUWA, SOUTH AFRICA

Abstract OBJECTIVE Pediatric brain tumours are the most common solid tumours affecting 30 000-40 000 children per year worldwide. These tumours are a leading cause of morbidity and mortality in children and adolescents worldwide. A single-center retrospective audit was performed to establish the characteristics of primary pediatric brain tumours at a tertiary referral hospital in Pretoria, South Africa. The study will help with setting up efficient screening and treatment protocols for pediatric neuro-oncology guarded by the study’s findings. METHODS The results from the analysis of the data recorded for the 29 patients in the study are presented in this chapter. The statistical analysis was descriptive, and all the procedures were performed on SAS (SAS Institute Inc, Cary, NC, USA), Release 9.4. RESULTS The most common age range was 0-4 years, with males (65.5%) affected more than females (34.5%). Headaches were reported in 69% of the patients, and vomiting was observed in 93.1%. Seizures were observed in 27.6% of patients and were associated with supratentorial tumours more than infratentorial tumours. On radiological examination, 45.5% of tumours were supratentorial, and the remainder, 54.5%, were infratentorial. Hydrocephalus was observed in 93.1% of patients and is associated mostly with infratentorial tumours. Pilocytic astrocytomas were the most common histological diagnosis at 20.7%, followed in second place by medulloblastomas and pineoblastomas, both at 10.3%. CONCLUSION The audit results are largely consistent with published literature in terms of gender profile, mean age at diagnosis, common presenting symptoms and signs and common histopathological types of Pediatric Brain Tumours. The small sample size and lack of sufficient clinical data make it difficult to make meaningful conclusions on some of the results.

The importance of drug symbols and halal logos in the pharmaceutical industry: Effect, understanding, and implementation

With its predominantly Muslim population, Indonesia has significant potential in pharmaceuticals and herbal products, making it a focal point for government initiatives to drive growth in the sector. Despite these efforts, compliance with halal standards and obtaining halal certificates still face many challenges. This research examines the efforts to fulfill halal certification obligations by implementing halal standards in pharmaceutical and herbal products. This research uses a descriptive qualitative study; the data was collected through observational reviews and interviews and supplemented with a comprehensive literature study, which includes various sources such as journals, books, online media, and other additional references. This study reveals that setting standards or halal certification involves three parties, namely the Halal Product Assurance Organizing Agency (BPJPH), the Halal Examining Agency (LPH), and the Indonesian Council of Ulama (MUI). BPJPH implements the halal product guarantee. Then BPJPH will submit it to Lembaga Pengkajian Pangan, Obat-obatan dan Kosmetika (LPPOM) as LPH to check the adequacy of documents, compile audits, conduct audits, hold auditor meetings, issue audit memoranda, and submit audit result records to the MUI Halal Fatwa Session. Together with the Fatwa Committee, MUI determines the level of halalness of the product based on the audit results and issues a MUI Halal Decree. Keywords: Herbs, Halal Industry, Halal Certificate, Medicines

Quality Improvements in Dementia Care in an Acute Hospital Setting

Abstract Background Dementia care in acute hospital settings requires targeted quality improvement initiatives based on national standards. This poster highlights key interventions to enhance care, aligning with local hospital group key performance indicators (KPIs), in one large teaching hospital. Methods Delirium screening (4AT) was implemented in the Emergency Department and geriatric ward, with education to increase staff awareness of delirium screening, prevention, and management. Audits assessed compliance with the 4AT tool. An audit evaluated the geriatric ward environment, including dementia-friendly painting, decorating, and signage, at baseline. Psychotropic prescribing practices were audited in 20 inpatient charts. A Life story Information tool (Sunflower Tool) was implemented to display personalized patient information at the end of the bed. Semi-annual audits assessed usage and effectiveness in the geriatric ward. Results The initial audit showed 85% compliance with the 4AT tool, dropping to 40% in a repeat audit after 6 months. Initially, 17 of 20 charts had complete 4AT scores; in the re-audit, 11 of 20 had scores recorded, with only 8 fully completed. The first environmental audit revealed poor compliance with dementia-friendly standards, especially in signage, clutter, and bedroom colour contrasts. Best compliance was seen with colour contrast in bathroom toilets and handrails. A quality improvement plan was developed to address gaps. The adoption and impact of the Sunflower tool improved patient-staff interactions and personalized care. All ward staff were trained in using the Sunflower tool. Conclusion A robust quality improvement plan, with measurable, achievable, relevant, and time-defined actions, aligned with national standards and local KPIs, is crucial to achieve and sustain positive audit results. Continuous education, resource allocation, and regular audits are required to ensure high-quality care for patients with dementia. Future efforts will focus on addressing identified challenges, refining interventions based on audit feedback, and maintaining care improvements.

A transcontinental threat: Plastic waste from Africa invades Brazil's coast

Identifying the origin of plastic pollution is essential for the development of effective preventive and mitigatory strategies and guidelines for companies, governments, and stakeholders. In 2022, a considerable amount of plastic waste stranded on beaches of the northeastern coast of Brazil. A preliminary analysis of this waste revealed that most of the items were likely foreign made, and a brand auditing approach was applied to identify the brands, parent companies, and potential origin of the plastic waste. The items were also examined to determine their degree of degradation, polymer resin codes, colors, and probable uses. Given their probable foreign origin, a numerical simulation was employed using the OpenDrift dispersion model to determine the likely route each item would have taken before reaching the Brazilian coast. The brand audit confirmed that most of the plastic waste came from Africa (78.5 % of the items), followed by Brazil (15.7 %), and other nations (5.8 %). A total of 31 brands from seven African countries were identified, of which, >90 % originated from the Democratic Republic of the Congo. Drift simulations were consistent with the results of the brand audit, indicating that the plastics originated from the west coast of African, primarily between latitudes 5° N and 10° S. This analysis indicated that the Congo river was the principal source of the plastic waste that found its way to the Brazilian beaches. The present study highlights the widespread occurrence of plastic pollution across the Atlantic Ocean and underscores the need for mitigatory and regulatory measures that consider foreign sources, as well as local drivers of pollution. In this context, continuous monitoring programs will be essential to advance our understanding of the magnitude of the international plastic pollution problem, and provide insights to delineate specific enforcements dealing with this issue.

Analysis of factors affecting on local government’s financial losses in North Sulawesi

This study intends to examine if internal control effectivity, audit findings, audit opinion, completion of follow up audit results and characteristics of regional head have impacts on local government’s financial losses. The study will use district and city local governments in North Sulawesi province as a case study to examine this relationship. Using a sample of 80 respondents in the year 2024, this study draws on primary sources to examine all of the local governments in North Sulawesi Province. Multiple linear regression analysis was processed by Smart PLS version 3.0 software program in order to analyze data and evaluate hypothesis. This study demonstrate that: (1) effectiveness of internal control system has a negative and significant effect on local government’s financial losses; (2) audit findings has negative and significant effect on local government’s financial losses; (3) audit opinion has negative and significant effect on local government’s financial losses; (4) completion of follow up audit results has negative and significant effect on local government’s financial losses; and (5) characteristics of regional heads has negative and significant effect on local government’s financial losses.

The Gendered Impact of Corruption Revelations: Unveiling the Role of Parties and Voters in Mexico

Studies have found that women’s representation is more likely to spike after corruption scandals. However, the mechanism underlying this increase remains unclear: are parties more likely to nominate women after corruption scandals, are voters more likely to support women candidates, or is it a combination of both? Using an original dataset of audit results and the gender of 47,000 candidates running in over 10,000 mayoral elections in Mexico (2000–2019), we find that voters drive the effect. While political parties are not more likely to nominate women as candidates in municipalities with recent revelations of spending irregularities, women candidates are more likely to win elections after corruption is uncovered. In contrast to previous studies, which expect strategic parties to be behind the increases in women’s representation following corruption scandals, our findings underscore that increases in women’s representation can happen despite parties and not because of parties.

Development of environmental auditing in Vietnam

In recent times, environmental auditing has played a very important role in gradually assessing environmental management, assessing the economy, efficiency, effectiveness and paying attention to environmental aspects. However, environmental auditing conducted by the State Audit is currently mainly integrated into financial statement audits and compliance audits. There are few environmental audits that are operational audits or are conducted independently, so the audit results have not been as expected. Keywords: Audit, Environment, Vietnam

Research on energy-saving renovation of old oceanarium based on energy consumption monitoring technology

This study takes an old oceanarium in Jiangsu Province, China, as a case study and monitors the energy consumption values related to electricity, water and gas consumption for the whole year before the renovation of the oceanarium. Based on the energy consumption monitoring data, an in-depth analysis of the energy consumption defects of the oceanarium before the renovation is conducted using energy audit technology. We combine the characteristics of the oceanarium itself according to: (1) the results of the building energy audit; (2) the results of the envelope calculation; and (3) the latest energy-saving retrofit technology. We developed a more scientific building energy-saving retrofit programme. Using this method, we can accurately monitor the energy consumption problems in old oceanarium buildings and find building energy consumption defects. In this study, we monitor the real-time energy consumption of nine old government office buildings in Jiangsu Province, China using energy monitoring technology. We analyse and study the monitoring results and finally target the scientific energy-saving retrofits. This method can be used to carry out targeted energy-saving building renovation in the future and put forward new methods and ideas for studying the energy consumption of existing public buildings.

EP442 - An Audit on the Application of Enhanced Recovery Post Emergency Laparotomy

Abstract Aim This audit aims to evaluate the efficiency of NG tube and catheter removal post emergency laparotomies, assess the occurrence of postoperative complications, and analyse hospital practices related to enhanced recovery in the context of emergency laparotomies. Methods Data was collected retrospectively from [Hospital Name] for a specified time period, including patient demographics, surgical details, time to NG tube and catheter removal, postoperative complications, and adherence to enhanced recovery protocols. The audit included a thorough review of medical records, nursing notes, and relevant documentation. Results Preliminary findings indicate variations in the time taken for NG tube and catheter removal across emergency laparotomy cases. The occurrence of postoperative complications, such as infections, delayed recovery, and prolonged hospital stays, was also assessed. Furthermore, an analysis of hospital practices, including the implementation of enhanced recovery protocols, was conducted. Conclusion The results of this audit will contribute valuable insights into the effectiveness of current practices related to NG tube and catheter management post emergency laparotomies. The findings may highlight areas for improvement in enhancing recovery, optimising patient outcomes, and minimising complications. Recommendations for refining hospital protocols and promoting timely interventions will be proposed based on the audit results, with the ultimate goal of improving the overall quality of care for patients undergoing emergency laparotomies.

Improving the Accuracy of the Gynaecology Handover Process: An Effective Quality Improvement Project at a University Hospital in the United Kingdom.

Objectives The objective of this study was to introduce a new system of handover in the gynaecology department and ensure its effectiveness with dynamic improvement measures. This was launched as a quality improvement project in a district general hospital in the United Kingdom. The primary aim was to start and consolidate a new system of a separate gynaecology handover in the presence of consultants, registrars (incoming and outgoing), senior house officers (incoming and outgoing) and gynaecology nurses. Design The strategy for consolidation included a daily quality review on the basis of a fixed proforma, identifying the obstacles faced, and improvising dynamic solutions. A new quality check proforma was introduced which took into account: (i) Presence of team members, (ii) Following of proper SBAR (Situation, Background, Assessment, Recommendation) format in the handover, (iii) Updating of patients awaiting surgeries with every detail on the list, (iv) Proper handing over of pending referrals, (v) Mention of sick patients with proper importance, and (vi) Proper handing over of new admissions. A pilot study was done to evaluate the baseline performance of the unit regarding the gynaecology team handover on the basis of the same proforma. The result of the baseline study was noted as the reference. Each day the team receiving the handover was interviewed for the next five months about the quality of each of the parameters on the predesigned proforma and the responses were noted. The answers were designed in binary form (Yes/No). These results were compiled at the end of each month. The result from each individual month was reviewed and the problems were identified and practical solutions were applied. These changes were noted and plotted graphically as a bar diagram. The monthly audit results were tabulated in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States). Results Pilot study results and final month results were compared with the help of the Mcnemar test and statistically significant improvement was noticed in seven out of eleven parameters. There was a steady and gradual improvement in the responses. The possible limitations of the study were also noted at the same time. Conclusion The quality improvement project was highly effective in improving the quality of handover and increased patient safety to a large extent.

S04-5: Lessons learned from the results of policy audits of multiple local governments

S04-5: Lessons learned from the results of policy audits of multiple local governments

Implementation of an Acute Pain Service in the Orthopedic Traumatology Department of the University Hospital of Batna.

Background and Objectives. Effective management of postoperative acute pain (POP) in surgical settings requires well-organized approaches. Our goal was to establish an economic model of the Acute Pain Service (APS), to ensure appropriate treatment of POP in adults undergoing orthopedic and traumatological surgery at the University Hospital Center of Batna between 2015 and 2017. Materials and Methods. A descriptive and evaluative study was conducted as part of a quality assurance initiative to establish a acute pain service (APS) between 2015 and 2017. This study focused on organization, training, information dissemination, and pain assessment. Participants included five medical practitioners, 37 paramedical professionals, as well as 104 patients audited before the PAS implementation and 136 patients audited after its establishment. All patients underwent orthopedic and traumatological surgeries. Results. The survey involved 5 physicians and 37 healthcare providers. The results of the reevaluation audit showed that practitioners acquired skills in 86% of cases, common protocols for managing postoperative pain (DPO) were present in 100% of cases, patient information was provided in 77% of cases, and the quality of DPO management was rated as good in 54% of cases. Conclusion. Implementing an organizational framework based on quality assurance principles led to a significant enhancement in postoperative pain management following the introduction of a functional analgesia unit of the acute pain service (APS).