Audit Tool Research Articles

Auditing the quality of epidemic decision-making in Somalia: a pilot evaluation

ObjectiveTo assess decision-making quality through piloting an audit tool among decision-makers responding to the COVID-19 epidemic in Somalia.Design and settingWe utilised a mixed-methods programme evaluation design comprising quantitative and qualitative...

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: Methods, Overview, and Principles.

Moderate to severe traumatic brain injury (TBI) results in complex cognitive sequelae. Despite hundreds of clinical trials in cognitive rehabilitation, the translation of these findings into clinical practice remains a challenge. Clinical practice guidelines are one solution. The objective of this initiative was to reconvene the international group of cognitive researchers and clinicians (known as INCOG) to develop INCOG 2.0: Guidelines for Cognitive Rehabilitation Following TBI. The guidelines adaptation and development cycle was used to update the recommendations and derive new ones. The team met virtually and reviewed the literature published since the original INCOG (2014) to update the recommendations and decision algorithms. The team then prioritized the recommendations for implementation and modified the audit tool accordingly to allow for the evaluation of adherence to best practices. In total, the INCOG update contains 80 recommendations (25 level A, 15 level B, and 40 level C) of which 27 are new. Recommendations developed for posttraumatic amnesia, attention, memory, executive function and cognitive-communication are outlined in other articles, whereas this article focuses on the overarching principles of care for which there are 38 recommendations pertaining to: assessment (10 recommendations), principles of cognitive rehabilitation (6 recommendations), medications to enhance cognition (10 recommendations), teleassessment (5 recommendations), and telerehabilitation intervention (7 recommendations). One recommendation was supported by level A evidence, 7 by level B evidence, and all remaining recommendations were level C evidence. New to INCOG are recommendations for telehealth-delivered cognitive assessment and rehabilitation. Evidence-based clinical algorithms and audit tools for evaluating the state of current practice are also provided. Evidence-based cognitive rehabilitation guided by these recommendations should be offered to individuals with TBI. Despite the advancements in TBI rehabilitation research, further high-quality studies are needed to better understand the role of cognitive rehabilitation in improving patient outcomes after TBI.

Инструментальные методы и их применение во внутреннем финансовом контроле и аудите бюджетного учёта и отчётности

Budgetary sphere is subject to the risks of budget accounting and reporting violations, which managers and accountants face. To reduce risks and confirm accuracy of accounting and reporting, modern control and audit tools are used at the level of departments and institutions. Internal control and audit in recent years are constantly being reformed and transformed on the basis of goals and objectives. Federal standards are used to regulate internal financial audit, and normative base for internal financial control is far from being perfect and is not very clear in practice. In this regard, there are many discrepancies, interpretations and understanding of organization of these types of control in institutions. The purpose of the study is to compare internal financial control and audit in the public sphere, substantiate the unity and opposite of the control purpose and describe verification methodology and the tools. The research methodology is based on application of monographic research methods, discussion, analysis of normative base, economic substantiation of the provisions of departmental regulations in the field of control and audit, comparative assessment of internal financial control and audit. As a result, comparative assessment of internal financial control and audit is given, and the relationship between internal financial control and audit is demonstrated. This relationship can be traced through the purpose of these types of control. The importance of methods, ways and techniques of control and audit as components of the tools of the controller and auditor is substantiated. It is shown which methods are used in practice by internal auditors, and which are used by internal controllers, and what methodological and instrumental relationship is between them.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: What's Changed From 2014 to Now?

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: What's Changed From 2014 to Now?

Why is the implementation of Robson’s classification required in Morocco?

In Morocco, the Ministry of Health has mobilized several efforts to improve maternal and newborn health over the past decades. Despite progress, the high risk of death during pregnancy, childbirth, and postnatal is still a concern. Obstetricians highly regard this and require them to undertake ongoing research to promote optimal pregnancy and birth outcomes. Medical techniques such as cesarean section have led to significant progress. However, the frequency of cesarean sections has increased recently, despite World Health Organisation (WHO) recommendations to stay within 15%. Controlling the rate of cesarean sections has become a significant public health concern, given the risk of morbidity and mortality associated with cesarean sections and the associated costs. Through a review of the literature, this research interprets and analyses the relevant data to highlight the contribution of Robson’s classification to controlling C-section indications and, consequently, their rates. Indeed, several original scientific studies recommend its adoption because of its objectivity and contribution to the effective reduction of cesarean section rates. Finally, as a main recommendation, the adoption of Robson’s classification in Morocco as a simple tool for evaluation, monitoring, and audit of cesarean section rates and its use is strongly recommended for better control of cesarean section rates and indications. The training of practitioners should support it.

Digitalization of accounting in the context of ensuring business competitiveness

The article highlights the importance of digitalization in the modern world for the development of accounting and audit. It is noted that the relatively recent development of information technology and computerization of all spheres of human activity have led to significant changes in approaches to business. These changes showed the need to apply digital technologies in all industries. Accounting and audit is no exception. The article explores the impact of digitalization on the development of accounting and audit. It is determined that the use of digital technologies can increase the accuracy of accounting and audit, reduce the possibility of errors and increase the speed of operations, reduces the cost of these processes and increases the efficiency of work. The use of digital technologies allows us to develop new methods and tools for accounting and audit, which is very important in changing business conditions. The article discusses the main challenges and obstacles that may arise during the digitalization of accounting and audit, for example, insufficient qualifications of personnel, high costs for the introduction of new technologies, problems with data security and insufficient understanding by customers of the possibilities of digitalization in accounting and audit. The need to constantly improve the skills of specialists in the field of accounting and audit is noted so that they can use new technologies and techniques in their work. It is noted that the use of digital technologies in accounting and auditing can make these processes more transparent and accessible to all parts, which is important in changing business conditions and the development of society as a whole. The article also discusses data security issues that may arise when using digital technologies in the field of accounting and auditing. The authors note that specialized software must be used to ensure data protection, and comply with relevant standards and regulations. It also emphasizes the importance of ensuring the confidentiality and protection of personal data of customers. Highlights the benefits of using cloud technologies to store and process data in accounting and auditing, the possibilities of using blockchain technologies to ensure data security are considered. In addition, the article discusses the introduction of digital technologies in auditing, in particular the use of data analytics and artificial intelligence. This allows you to increase the efficiency and accuracy of the audit process, and also provide a wider scope of data analysis. Based on the analysis, the author of the article concludes, that digitalization is a promising direction for the development of accounting and audit. Recommendations for the implementation of digital technologies in the field of accounting and audit, in particular, it is recommended to ensure data security, comply with relevant standards and rules, use specialized software tools, and ensure the confidentiality and protection of personal data. The article offers new approaches to the use of technologies in the field of accounting and auditing, and emphasizes that, the use of digital technologies can improve the efficiency and accuracy of the accounting and audit process. The introduction of digital technologies in the field of accounting and audit is a necessary step in the development of these industries, therefore, their use can provide a competitive advantage for enterprises.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part III: Executive Functions.

Moderate-to-severe traumatic brain injury (MS-TBI) causes debilitating and enduring impairments of executive functioning and self-awareness, which clinicians often find challenging to address. Here, we provide an update to the INCOG 2014 guidelines for the clinical management of these impairments. An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated recommendations for the management of executive functioning and self-awareness post-MS-TBI, as well as a decision-making algorithm, and an audit tool for review of clinical practice. A total of 8 recommendations are provided regarding executive functioning and self-awareness. Since INCOG 2014, 4 new recommendations were made and 4 were modified and updated from previous recommendations. Six recommendations are based on level A evidence, and 2 are based on level C. Recommendations retained from the previous guidelines and updated, where new evidence was available, focus on enhancement of self-awareness (eg, feedback to increase self-monitoring; training with video-feedback), meta-cognitive strategy instruction (eg, goal management training), enhancement of reasoning skills, and group-based treatments. New recommendations addressing music therapy, virtual therapy, telerehabilitation-delivered metacognitive strategies, and caution regarding other group-based telerehabilitation (due to a lack of evidence) have been made. Effective management of impairments in executive functioning can increase the success and well-being of individuals with MS-TBI in their day-to-day lives. These guidelines provide management recommendations based on the latest evidence, with support for their implementation, and encourage researchers to explore and validate additional factors such as predictors of treatment response.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part IV: Cognitive-Communication and Social Cognition Disorders.

Moderate to severe traumatic brain injury causes significant cognitive impairments, including impairments in social cognition, the ability to recognize others' emotions, and infer others' thoughts. These cognitive impairments can have profound negative effects on communication functions, resulting in a cognitive-communication disorder. Cognitive-communication disorders can significantly limit a person's ability to socialize, work, and study, and thus are critical targets for intervention. This article presents the updated INCOG 2.0 recommendations for management of cognitive-communication disorders. As social cognition is central to cognitive-communication disorders, this update includes interventions for social cognition. An expert panel of clinicians/researchers reviewed evidence published since 2014 and developed updated recommendations for interventions for cognitive-communication and social cognition disorders, a decision-making algorithm tool, and an audit tool for review of clinical practice. Since INCOG 2014, there has been significant growth in cognitive-communication interventions and emergence of social cognition rehabilitation research. INCOG 2.0 has 9 recommendations, including 5 updated INCOG 2014 recommendations, and 4 new recommendations addressing cultural competence training, group interventions, telerehabilitation, and management of social cognition disorders. Cognitive-communication disorders should be individualized, goal- and outcome-oriented, and appropriate to the context in which the person lives and incorporate social communication and communication partner training. Group therapy and telerehabilitation are recommended to improve social communication. Augmentative and alternative communication (AAC) should be offered to the person with severe communication disability and their communication partners should also be trained to interact using AAC. Social cognition should be assessed and treated, with a focus on personally relevant contexts and outcomes. The INCOG 2.0 recommendations reflect new evidence for treatment of cognitive-communication disorders, particularly social interactions, communication partner training, group treatments to improve social communication, and telehealth delivery. Evidence is emerging for the rehabilitation of social cognition; however, the impact on participation outcomes needs further research.

The Value of POSSUM & P-POSSUM as Surgical Audit Tool Predicting Morbidity and Mortality in Emergency Laparotomy

The Value of POSSUM & P-POSSUM as Surgical Audit Tool Predicting Morbidity and Mortality in Emergency Laparotomy

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part II: Attention and Information Processing Speed.

Moderate to severe traumatic brain injury (MS-TBI) commonly causes disruption in aspects of attention due to its diffuse nature and injury to frontotemporal and midbrain reticular activating systems. Attentional impairments are a common focus of cognitive rehabilitation, and increased awareness of evidence is needed to facilitate informed clinical practice. An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated guidelines for the management of attention in adults, as well as a decision-making algorithm, and an audit tool for review of clinical practice. This update incorporated 27 studies and made 11 recommendations. Two new recommendations regarding transcranial stimulation and an herbal supplement were made. Five were updated from INCOG 2014 and 4 were unchanged. The team recommends screening for and addressing factors contributing to attentional problems, including hearing, vision, fatigue, sleep-wake disturbance, anxiety, depression, pain, substance use, and medication. Metacognitive strategy training focused on everyday activities is recommended for individuals with mild-moderate attentional impairments. Practice on de-contextualized computer-based attentional tasks is not recommended because of lack of evidence of generalization, but direct training on everyday tasks, including dual tasks or dealing with background noise, may lead to gains for performance of those tasks. Potential usefulness of environmental modifications is also discussed. There is insufficient evidence to support mindfulness-based meditation, periodic alerting, or noninvasive brain stimulation for alleviating attentional impairments. Of pharmacological interventions, methylphenidate is recommended to improve information processing speed. Amantadine may facilitate arousal in comatose or vegetative patients but does not enhance performance on attentional measures over the longer term. The antioxidant Chinese herbal supplement MLC901 (NeuroAiD IITM) may enhance selective attention in individuals with mild-moderate TBI. Evidence for interventions to improve attention after TBI is slowly growing. However, more controlled trials are needed, especially evaluating behavioral or nonpharmacological interventions for attention.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part V: Memory.

Memory impairments affecting encoding, acquisition, and retrieval of information after moderate-to-severe traumatic brain injury (TBI) have debilitating and enduring functional consequences. The interventional research reviewed primarily focused on mild to severe memory impairments in episodic and prospective memory. As memory is a common focus of cognitive rehabilitation, clinicians should understand and use the latest evidence. Therefore, the INCOG ("International Cognitive") 2014 clinical practice guidelines were updated. An expert panel of clinicians/researchers reviewed evidence published since 2014 and developed updated recommendations for intervention for memory impairments post-TBI, a decision-making algorithm, and an audit tool for review of clinical practice. The interventional research approaches for episodic and prospective memory from 2014 are synthesized into 8 recommendations (6 updated and 2 new). Six recommendations are based on level A evidence and 2 on level B. In summary, they include the efficacy of choosing individual or multiple internal compensatory strategies, which can be delivered in a structured or individualized program. Of the external compensatory strategies, which should be the primary strategy for severe memory impairment, electronic reminder systems such as smartphone technology are preferred, with technological advances increasing their viability over traditional systems. Furthermore, microprompting personal digital assistant technology is recommended to cue completion of complex tasks. Memory strategies should be taught using instruction that considers the individual's functional and contextual needs while constraining errors. Memory rehabilitation programs can be delivered in an individualized or mixed format using group instruction. Computer cognitive training should be conducted with therapist guidance. Limited evidence exists to suggest that acetylcholinesterase inhibitors improve memory, so trials should include measures to assess impact. The use of transcranial direct current stimulation (tDCS) is not recommended for memory rehabilitation. These recommendations for memory rehabilitation post-TBI reflect the current evidence and highlight the limitations of group instruction with heterogeneous populations of TBI. Further research is needed on the role of medications and tDCS to enhance memory.

Evaluation of the England Community Pharmacy Quality Scheme (2018–2019 and 2019–2020) in reducing harm from NSAIDs in older patients

IntroductionNon-steroidal anti-inflammatory drugs (NSAIDs) are widely used for their analgesic and anti-inflammatory action, but the gastrointestinal (GI) adverse effects are a known cause of preventable harm. A medication safety audit...

МЕТОДИЧЕСКИЕ АСПЕКТЫ ВНУТРЕННЕГО АУДИТА ОСНОВНЫХ БИЗНЕС-ПРОЦЕССОВ ОРГАНИЗАЦИИ

The article discusses the elements of the internal control system, gives an interpretation of the term internal financial control, notes the problems of lack of internal regulations and the non-use of modern procedures and control methods, classifies business processes and lists business process audit tools. The authors give the stages of internal audit of business processes, list the control procedures for checking the business process of production. In the final part of the article, the structure of the internal standard “Methodology for internal audit of the organization’s main business processes” is proposed.

The impact of forensic accounting tools in investigating white-collar crime

This study examines the impact of forensic accounting tools in the investigation of white-collar crime in Malaysia. Models consist of multiple regression has been evaluated. Our results show, the impact Encase software, Computer Aided Audit Tools (CAAT), Forensic Toolkit (FTK), and ProDiscover Forensics have a significant relationship with investigating white-collar crime in Malaysia. Firstly, Encase is widely acknowledged as the world's premier provider of digital forensics, cyber security, and electronic discovery, making it the gold standard for criminal digital forensics. Secondly, CAAT allows a database of thousands of transactions to be centrally audited and finished more efficiently and quickly. Thirdly, FTK's primary purpose is speed and performance, hence it concentrates on pre-indexing files to improve speed. It is compatible with electronic discovery and mobility. Lastly, ProDiscover is a great computer security tool because it enables computer specialists to swiftly locate all data on computer disks and safeguard evidence for use in legal procedures. This study raises awareness of forensic accounting tools to investigate white-collar crime more effectively.

A cross-sectional study of prescription audit in outpatient departments of tertiary care hospital

Background: Prescriptions are medico-legal documents, and it is the duty of every physician to write a complete, legible, and valid prescription to ensure rational drug use and prevent the occurrence of medication errors. A periodic prescription audit is required for the identification of common deficiencies in the prescriptions and to undertake corrective measures for improving the prescribing practices. This is a quality improvement process that seeks to improve patient care. It supports health professionals in making sure their patients receive the best possible care. Aims and Objectives: To find out the common areas of noncompliance in prescriptions by using the prescription audit tool by the National Health Mission. Materials and Methods: A cross-sectional study of prescription audits was conducted using the prescription audit tool by the National Health Mission. Prescriptions were randomly taken from various clinical outpatient departments according to the percentage they contribute to the outpatient population. This tool contains both indicators to check the completeness of the prescription and indicators for the legibility and rationality of the prescription. 235 prescriptions were audited, and the parameters that scored low were identified. Results: The lowest score was seen with parameters like mentioning allergy status (4.89%), duly signing prescriptions (44%), recording follow-up advice and precautions (19%), and mentioning the review date (16.8%). Parameters that need improvement are recording the brief history and salient features of the clinical examination, to write the presumptive diagnosis. Conclusion: Conducting prescription audits frequently in all hospitals help in better understanding the prescribing behavior of the physicians, and followed by constant communication and training of the physicians, this is the most effective way to improve prescription practice within the hospital.

VALIDATION OF A TOOL TO MEASURE THE LEVEL OF SCHOOL-UNIVERSITY PARTNERSHIP

This study aims at developing and validating an audit tool that could be used to assess school-university partnerships. Specifically, the study followed four steps of (i) evaluating and modifying contents and items of the original tool, (ii) qualitatively assessing content validity of the revised scale basing on expert ratings, and revising the scale accordingly, (iii) conducting cognitive interviews with potential participants, and making further revision, and (iv) quantitatively evaluating the validity and reliability of the audit tool based on data collected from 463 participants, and finalizing the tool. In the end, an audit tool consisting of 36 questions that fit into two scales (i.e., “Shared goals and values” and “Partnership operations and management”) was confirmed. The study also discussed potential uses of the tool for both currently working partnerships and newly formed partnerships; and at different levels.

Comparing the appropriateness of antimicrobial prescribing among medical patients in two tertiary hospitals in Malaysia.

Malaysia is an upper-middle-income country with national antimicrobial stewardship programs in place. However, hospitals in this country are faced with a high incidence of multidrug-resistant organisms and high usage of broad-spectrum antibiotics. Therefore, this study aimed to use a standardized audit tool to assess clinical appropriateness, guideline compliance, and prescribing patterns of antimicrobial use among medical patients in two tertiary hospitals in Malaysia to benchmark practice. A prospective hospital-wide point prevalence survey was carried out by a multidisciplinary team in April 2019 at the University Malaya Medical Centre (UMMC) and the Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. Data was collected from the patient's electronic medical records and recorded using the Hospital National Antimicrobial Prescribing Survey toolkit developed by the National Centre for Antimicrobial Stewardship, Australia. The appropriateness of prescriptions was 60.1% (UMMC) and 67% (HCTM), with no significant difference between the two hospitals. Compliance with guidelines was 60.0% (UMMC) and 61.5% (HCTM). Amoxicillin-clavulanic acid was the most commonly prescribed antimicrobial (UMMC = 16.9%; HCTM = 11.9%). The appropriateness of antimicrobial prescribing in medical wards, compliance with guidelines, and prescribing patterns were similar between the two hospitals in Malaysia. The survey identified several areas of prescribing that would need targeted AMS interventions.

Exploring and developing crime prevention through environmental design (CPTED) audits: an iterative process

This paper utilizes an ecological perspective to explore the development of a crime prevention through environmental design (CPTED) audit tool through an ongoing iterative process. We draw upon existing examples from criminology and research into auditing the built environment for physical activity and active travel. The purpose of the paper is to present a revised CPTED audit tool and process to assist those managing crime and anti-social behaviour in their streets, neighbourhoods and communities. It may also assist those seeking to use audits as part of the CPTED process set out in the recent International Standards on CPTED: ISO22341 (British Standards 2021). Following Ceccato (Crim Justice Stud 32:165–188, 2019), we briefly reflect on the validity, reliability and generalizability of the CPTED audit tool and consider further possible refinements for future iterations.

Street environments and crime around low-income and minority schools: Adopting an environmental audit tool to assess crime prevention through environmental design (CPTED)

Crime prevention through environmental design (CPTED) suggests an association between micro-scale environmental conditions and crime, but little empirical research exists on the detailed street-level environmental features associated with crime near low-income and minority schools. This study focuses on the neighborhoods around 14 elementary schools serving lower income populations in Seattle, WA to assess if the distribution of crime incidences (2013–2017) is linked with the street-level environmental features that reflect CPTED principles. We used a total of 40 audit variables that were included in the four domains derived from the broken windows theory and CPTED principles: natural surveillance (e.g., number of windows, balconies, and a sense of surveillance), territoriality (e.g., crime watch signs, trees), image/maintenance (e.g., graffiti and a sense of maintenance/cleanness), and geographical juxtaposition (e.g., bus stops, presence of arterial). We found that multiple crime types had significant associations with CPTED components at the street level. Among the CPTED domains, two image/maintenance features (i.e., maintenance of streets and visual quality of buildings) and two geographical juxtaposition features (i.e., being adjacent to multi-family housing and bus stops) were consistently associated with both violent and property crime. The findings suggest that local efforts to improve maintenance of streets and visual quality of buildings and broader planning efforts to control specific land uses near schools are important to improve safety in marginalized neighborhoods near schools that tend to be more vulnerable to crime. Our research on micro-scale environmental determinants of crime can also serve as promising targets for CPTED research and initiatives.

Nursing staff communication with pediatric patients and families in a pediatric transitional care unit: a best practice implementation project.

The objective of this project was to promote evidence-based practices regarding nursing communication with pediatric patients/families. Effective communication between healthcare providers and patients/families is an essential component of patient care and plays a vital role in patient outcomes. Ineffective communication among the healthcare team and patient families has been described as a significant factor contributing to adverse events and poor health outcomes. The project used JBI's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for encouraging evidence-based practices. A baseline audit was conducted, followed by the implementation of targeted strategies. The project was completed with a follow-up audit to determine change in practice. Three evidence-based practices were utilized as audit criteria for the project. The baseline audit on the three audit criteria revealed an average compliance of 30%. After providing communication skills training to nursing staff and education and visual aids to patients/families and nursing staff regarding the use of white boards, follow-up audits revealed an average compliance of 62%, an increase of 32%. These implementation strategies will continue to be utilized on the unit and will be implemented in other areas of the hospital to further improve communication between patients/families and their healthcare team.