Audit Form Research Articles

Key trends and features of non-financial information audit on sustainable development as a promising form of management audit

Key trends and features of non-financial information audit on sustainable development as a promising form of management audit

Factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda

Introduction: Acute kidney injury (AKI) remains one of the complications of severe malaria. Evidence on associated factors and outcomes for patients with complicated malaria and AKI is limited in Rwanda. Aim: To assess the factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda. Method: A retrospective study design was applied. A census sampling strategy was used to select 122 files of patients admitted as severe malaria patients in 2016- 2017. A developed clinical audit form was used to collect data from patients’ files. Both descriptive and inferential statistics were used to analyze data. Results: Among the confirmed severe malaria files, 44% of participants were over 50 years and 52.5% were males. The majority, (91.5%) had community-based health insurance and 16.3% had acute kidney injury. The significant associated clinical factors were dehydration (p=.01), high-grade fever (p=.002), profuse sweating (p=.034), vomiting (p=.043), and diarrhea (p=.025). Of the 20 patients who developed AKI, 55% completely recovered, 15% died and 30% of cases were transferred to the highest facilities for hemodialysis. Conclusion: The existence of AKI among severe malaria patients was evident with some recovering and others dying. There is a need for educating healthcare professionals, mostly at district hospitals about the diagnosis and management of AKI as a result of complicated malaria. Keywords: Acute kidney injury; severe malaria; complications of malaria.

Why and how do suppliers develop environmental management capabilities in response to buyer-led development initiatives?

PurposeAlthough buying firms increasingly adopt supplier development to help suppliers enhance their ability to deal with environmental issues, little is known about the mechanisms by which buyer-led environmental supplier development (ESD) affects the environmental management capabilities (EMC) of suppliers. Focusing on the supplier perspective and specifically on the role of psychological mechanisms at the supplier level, the authors adopt the stimulus–organism–response framework from functionalist psychology to investigate the mediating role of environment-related supplier perceived relationship value in the association between ESD, in the form of environmental requirements and audits (indirect development – ID) vs. direct development projects (direct development – DD), and supplier EMC.Design/methodology/approachThe authors used structural equation modeling and regression analysis to test the hypotheses using survey data from 221 supplying organizations in China.FindingsResults reveal that each of the three considered dimensions of the environment-related supplier perceived relationship value (i.e. economic, strategic and co-creation) helps enhance EMC. However, while DD influences positively all three dimensions, ID has a positive effect on only the economic and strategic dimensions. Moreover, the mediation analysis suggests that, while DD affects EMC both directly and via the three dimensions of environment-related supplier perceived relationship value (partial mediation), ID affects EMC only through its impact on environment-related supplier perceived relationship economic and strategic value (full mediation).Originality/valueThe study sheds light on the psychological mechanisms that drive suppliers’ involvement in green supplier development activities. By doing so, it contributes to the understanding of ESD practices and processes and their effectiveness.

Zagregowane wskaźniki w ocenie jakości wybranych serwisów geoinformacyjnych

Map portals can facilitate the work of public administration units and improve access to information, although they have to present high material and technical quality. Not without significance are also measures supporting these websites. This paper aims to assess the quality of selected geoinformation websites. The study was carried out in the form of a quality audit with the use of selected web applications provided in a freeware, thin-client model. A comparative analysis was performed on three versions of the geoservice functioning for the Tomice municipality (accessed on 5th July 2023): 1) eMPZP website (https://www.tomice.pl/mpzp/), 2) municipal geoportal (http://www.mpzp.tomice.pl), and 3) municipal map portal (https://sip.gison.pl/tomice). The measurements were taken only once and in an ad hoc manner. The tests were performed in selected quality dimensions: responsiveness, performance, content and hyperlink quality, accessibility for people with disabilities, syntactic code correctness, search engine optimisation (SEO), and usage indicators, with special emphasis on overall quality. The conclusion was that each of the geoportals evaluated presents good quality. However, it would be wrong to compare them in absolute terms, as the quality of these services should be assessed through the lens of the different times in which they operate.

A Nurse-Driven Plan to Diminish First-Case Operating Room Delays.

The purpose of this study was to examine the use of a nurse-driven plan to describe factors associated with delays in the 1st case on time start within the operating room. A posttest-only quasi-experiment was conducted to examine the effect of designating specific time periods for steps in the preoperative process on 1st case operating delays. Rationale for delays was also examined. Using an audit form, data on target time, time met, delay in minutes, and reasons for delay were collected by an observer. Thirty-one percent (n = 31) of patient/participants (N = 99) were late to the operating room. Controllable factors, such as caregivers being late, and uncontrollable factors, such as patients' needing to use the restroom just prior to surgery, were identified. Results of this study support the identification and examination of steps in the preoperative process to prevent delays by adjusting activities as needed. Identifying controllable and uncontrollable factors can help in preparing to prevent delays.

Constructing an Automated Quality Control Indicator Dashboard by Linking Cloud-Based Forms with POWER BI.

This paper examines the use of quality control indicator audits in healthcare services to identify potential risk issues and improve the quality of medical care. A multi-stage approach was adopted to establish audit tools. This involved creating a cloud-based assessment form using Microsoft Form, developing Power BI dashboards connected to databases, and creating a mobile application for on-the-go auditing and result retrieval. Mobile application has replaced the need to search for and print audit forms, reducing paper usage. Automated audit results are linked to Power BI dashboards, significantly reducing the time spent on manual documentation and chart analysis, saving an average of 40 minutes per audit indicator. The paper proposes that the dashboard's real-time and automated features assist managers in promptly identifying potential issues and taking necessary intervention and guidance measures. These findings emphasise the significance of quality control indicator audits in enhancing the quality and safety of healthcare services.

Evaluation of hand hygiene practices of health care workers in tertiary care hospital by systematic hand hygiene audits

: Hand hygiene (HH) holds a pivotal role in infection control. However, compliance with hand hygiene has remained low worldwide. Hospital Acquired Infection (HAI) incidence is rising in most healthcare facilities. It is postulated that around 30% of HAI can be reduced by following strict hand hygiene protocols by healthcare workers (HCWs). This study was done to evaluate the level of compliance of healthcare personnel in our tertiary care hospital with respect to appropriate hand hygiene practices by employing HH audits. A cross-sectional observational study was conducted in a tertiary care teaching hospital over six months. A single‑ observer direct observation technique was used to collect the HH compliance data conducted by trained Infection control nurses. HCWs, including doctors, nurses, CRMIs and technicians, were observed for compliance in all the critical areas, outpatient and inpatient sections across all departments. The HH audit form designed based on the WHO's HH audit tool kit was used in the study. The audits were conducted randomly in all the areas for at least 20 minutes per day. : A total of 583 HCWs were observed for the Hand Hygiene Compliance audit. The overall HH compliance rate was 67.88%, with doctors at 74.31%, followed by nurses at 70.42%. Compliance was observed in OBG/Labour ward at 78.7% and the oncology ward at 78.5%. WHO moments-specific hand hygiene adherence showed the least compliance rate of 55% for moment 1, followed by moment 5 with 58.9%. Best compliance was observed for moment 3, with 79.2%.: The overall hand hygiene compliance was comparatively better in our study. Specific measures such as improved facilities, training and monitoring are needed to attain good H`H compliance.

Innovative pedagogical technologies in the modernization teaching of morphological disciplines

This article describes the experience of using innovative pedagogical technologies in the teaching process of morphologic disciplines. The need for such modernization associated with approval of the Federal State educational standards and requirements for building the necessary set of competencies for the future doctor. Application of innovative pedagogical Technologies expands the possibilities of preparing students for the newer forms of external audit of the residual knowledge of students, develops clinical thinking, more successfully prepares for upcoming Professional activity.

Once-per-week haemodialysis in a financial crisis: Predictors of interdialytic weight gain.

Several countries are experiencing challenges in maintaining standard haemodialysis services for people with kidney failure. This study aimed to investigate the health profile of people receiving haemodialysis and to identify factors associated with interdialytic weight gain. A cross-sectional study. A total of 166 adults with kidney failure and receiving haemodialysis for at least 3 months were included. A structured chart audit form collected, demographic and haemodialysis treatment characteristics, recent biochemical and haematological results, and prescribed treatment regimens from clinical records. Data were analysed descriptively. Odds ratios (OR) were calculated to identify independent risk factors for interdialytic weight gain. Mean age was 52 years (SD = 12.5), over half were male (60.2%, n = 100), and most were receiving 4 h of haemodialysis once per week (87.3%, n = 145). Approximately half (51.8%, n = 86) had an interdialytic weight gain >2%. Being female (OR = 3.39; 95% CI, 1.51-7.61), increased comorbidities (OR = 1.50; 95% CI, 1.22-1.84) and having BMI outside of the normal range (overweight/obese [OR = 8.49; 95% CI, 3.58-20.13] or underweight [OR = 4.61; 95% CI, 1.39-15.31]) were independent risk factors for increased interdialytic weight gain. Most patients were receiving 4 h of haemodialysis once per week although only modest alterations in potassium, phosphate, and fluid status were observed. Understanding the patient profile and predictors of interdialytic weight gain will inform the development of self-management interventions to optimise clinician support.

A physiologically-based digital twin for alcohol consumption—predicting real-life drinking responses and long-term plasma PEth

Alcohol consumption is associated with a wide variety of preventable health complications and is a major risk factor for all-cause mortality in the age group 15-47 years. To reduce dangerous drinking behavior, eHealth applications have shown promise. A particularly interesting potential lies in the combination of eHealth apps with mathematical models. However, existing mathematical models do not consider real-life situations, such as combined intake of meals and beverages, and do not connect drinking to clinical markers, such as phosphatidylethanol (PEth). Herein, we present such a model which can simulate real-life situations and connect drinking to long-term markers. The new model can accurately describe both estimation data according to a χ2 -test (187.0 < Tχ2 = 226.4) and independent validation data (70.8 < Tχ2 = 93.5). The model can also be personalized using anthropometric data from a specific individual and can thus be used as a physiologically-based digital twin. This twin is also able to connect short-term consumption of alcohol to the long-term dynamics of PEth levels in the blood, a clinical biomarker of alcohol consumption. Here we illustrate how connecting short-term consumption to long-term markers allows for a new way to determine patient alcohol consumption from measured PEth levels. An additional use case of the twin could include the combined evaluation of patient-reported AUDIT forms and measured PEth levels. Finally, we integrated the new model into an eHealth application, which could help guide individual users or clinicians to help reduce dangerous drinking.

A rapid improvement event: progesterone prescribing in prevention of miscarriage

A rapid improvement event (RIE) is a standard operational excellence technique that uses team-based problem solving to improve processes. In this study, a RIE was undertaken to improve progesterone prescribing...

Integration of Strategic Management and SIJAMIN Application in Improving the Quality of Higher Education

This research aims to analyze the integration of strategic management using SIJAMIN to conduct internal quality audits (IQA) at Universitas Malikussaleh in Lhokseumawe. This research used a qualitative approach with a descriptive method. Data collection techniques through observation, interviews with the Head, Secretary, Head of the Audit Center, and Accreditation Supervisor of the Learning Development and Quality Assurance Institute (LP3M), and documentary analysis to examine and evaluate the 2020-2024 Strategic Plan. This data analysis technique used interactive model analysis. Research validity was ensured through data triangulation, utilizing multiple data sources to guarantee the accuracy and reliability of findings. The results indicated that strategic management was implemented using the SWOT analysis model. The University's strategic plan for 2020-2024 focused on the policy of independent learning as a guideline for human resource development, considering global trends such as technological advancements. SIJAMIN is one of UNIMAL's missions in the technology field and is used to implement the Internal Quality Assurance System (SPMI), held annually in the form of internal quality audits (IQA). The application of SIJAMIN in the 6th IQA cycle showed that it could facilitate real-time data-driven decision-making, improve operational efficiency, and strengthen coordination among units. Additionally, there was progress in achieving strategic goals and enhancing the quality of teaching, research, and community service, with the expectation of achieving excellent accreditation. In conclusion, integrating strategic management and implementing SIJAMIN is a practical strategic step in improving the quality of higher education, particularly at Universitas Malikussaleh.

Development and pilot testing of a maturity assessment instrument for testbeds in health care

High-quality testbed services play a key role in the development and testing of new innovations for health care. To ensure that the development and testing process is valid and reliable, the testbed itself should fulfil a certain maturity level. The objectives of this study were to develop and pilot a new maturity assessment instrument for health care testbeds and to assess the maturity level of participating testbeds using self-assessment auditing. The data were collected in 2022 from 11 health care testbeds in Finland using the developed Health Care Testbed Maturity Assessment (HCTM) instrument in the form of auditing. The data were analysed using descriptive statistical analysis. According to the study results, the average maturity level of the participating testbeds was 51%. The developed instrument indicated preliminary feasibility for assessing the maturity of health care testbeds. Further development and validation of the instrument are warranted.

DEVELOPMENT OF SCIENTIFIC AND METHODOLOGICAL PRINCIPLES FOR PREVENTING ESG-MIMICRY BY BUSINESS ENTITIES

The scientific article examines the issues of destructive phenomena in society, the creation of information asymmetry and the distortion of the actual state of affairs, disinformation for obtaining illegal competitive advantages, image improvements and access to ESG-investments, which nullify efforts to achieve the goals of sustainable development (SDG), introduces misleading investors and discredits the essence of ESG activity of enterprises/companies and is a direct deception of consumers and other stakeholders. The concept of ESG-mimicry is defined from the point of view of the actions of enterprises/companies aimed at creating false, false information about its corporate responsibility, environmental and social activity. Studying the basics of ESG mimicry, as well as its application, gives enterprises/companies a clear understanding of the consequences of its influence. It is the awareness of this aspect that creates a fundamental basis for successful management of ESG-mimicry, which consists of certain elements: ensuring information transparency of the enterprise/company; active communications with stakeholders, since, as a rule, it is precisely in these areas of activity that ESG-mimicry appears most often, and here an important element is control over communications in the form of an ESG audit, internal (independent directors of enterprises/companies) and external mechanisms ( ESG labeling). The main methods of manipulation and forms of ESG mimicry are considered and characterized. Based on the results of the study, measures to prevent them were developed and proposed, as well as basic methods of combating ESG-mimicry in terms of stakeholders were proposed. The conducted research made it possible to propose scientific and methodological principles for combating ESG-mimicry, which include the definition of forms and methods of ESGmimicry, the main negative consequences of its use for the enterprise/company, and recommendations for preventing ESG-mimicry.

Neonatal near-miss audits: a systematic review and a call to action

BackgroundNeonatal near-miss (NNM) can be considered as an end of a spectrum that includes stillbirths and neonatal deaths. Clinical audits of NNM might reduce perinatal adverse outcomes. The aim of this review is to evaluate the effectiveness of NNM audits for reducing perinatal mortality and morbidity and explore related contextual factors.MethodsPubMed, Embase, Scopus, CINAHL, LILACS and SciELO were searched in February/2023. Randomized and observational studies of NNM clinical audits were included without restrictions on setting, publication date or language. Primary outcomes: perinatal mortality, morbidity and NNM. Secondary outcomes: factors contributing to NNM and measures of quality of care. Study characteristics, methodological quality and outcome were extracted and assessed by two independent reviewers. Narrative synthesis was performed.ResultsOf 3081 titles and abstracts screened, 36 articles had full-text review. Two studies identified, rated, and classified contributing care factors and generated recommendations to improve the quality of care. No study reported the primary outcomes for the review (change in perinatal mortality, morbidity and NNM rates resulting from an audit process), thus precluding meta-analysis. Three studies were multidisciplinary NNM audits and were assessed for additional contextual factors.ConclusionThere was little data available to determine the effectiveness of clinical audits of NNM. While trials randomised at patient level to test our research question would be difficult or unethical for both NNM and perinatal death audits, other strategies such as large, well-designed before-and-after studies within services or comparisons between services could contribute evidence. This review supports a Call to Action for NNM audits. Adoption of formal audit methodology, standardised NNM definitions, evaluation of parent’s engagement and measurement of the effectiveness of quality improvement cycles for improving outcomes are needed.

Improving timely melphalan administration completion for recipients of autologous stem cell transplant.

372 Background: Melphalan hydrochloride is a primary agent used in the conditioning regimen for autologous stem cell transplant indications including multiple myeloma and lymphoma. Brand Alkeran labelling indicates the drug concentration must not exceed 0.45 mg/mL and should be given over a minimum 15 minutes but infused in its entirety within 60 minutes from preparation. Caution is provided as data has shown a loss of potency by 1% every 10 minutes after melphalan dilution. Time and concentration constraints often require the dose being divided into two infusion bags with the option to Y-site. These limitations necessitated an optimized process to ensure melphalan completion within the 60-minute timeframe. Methods: Our institution began to formally audit melphalan administration data in November 2018 as part of a new program quality metric. A retrospective evaluation was performed which assessed the total time from melphalan dilution in a normal saline (NS) bag to melphalan infusion completion. The aim was to increase compliance within 60 minutes from 86.2% to 100%. We utilized the Plan-Do-Study-Act (PDSA) cycle method to address opportunities for improvement. PDSA 1 included staff education on the importance of timely administration; same-day audit forms were created to dissect any potential fallouts promptly. This form included documentation of the time from vial reconstitution to delivery to the pharmacist within the patient care unit. Secondary to re-evaluation of package insert verbiage and discussion with the manufacturer, we redefined the audit start time to be melphalan vial reconstitution instead of dilution in the infusion bag. PDSA 2 incorporated specific checkpoints for vial reconstitution (12 minutes) and bag delivery (20 minutes) and changed from concurrent to sequential bag administration. Results: A total 285 melphalan infusions were eligible for analysis (mean 1.91 bags per patient). Baseline data showed 86.2% of infusions completed within the 60-minute timeframe. Average time-to-completion was 50.2 minutes (N=73). PDSA 1 revealed 100% compliance of chemotherapy verification documentation and 97.9% infusion completion with an average time of 42.8 minutes (N=97). PDSA 2 resulted 99.1% compliance (one infusion fallout) and an average completion time of 41.2 minutes (N=115). Overall survival (OS) at 1-year for baseline, PDSA 1, and PDSA 2 groups was 94.7%, 95.9%, and 98.3% respectively ( p=0.66). Conclusions: The outcome measure average and mean time-to-completion improved from 86.2% to 99.1% and 50.2 to 41.2 minutes, respectively, secondary to process measure implementation despite the more stringent redefined vial dilution start time. A lone fallout of 62 minutes in PDSA 2 was triaged and determined to be due to unpredictable line complications. No significant differences in OS were observed. Ultimately, our process was optimized in terms of both compliance and efficiency.

Differences between centers in functional outcome of patients with ADHD after 1 year from the time of diagnosis

Although the pharmacological therapy of ADHD has been widely studied, little has been done to compare the different therapeutic approaches (e.g., drug therapy vs. psychological treatments) and even less has been done to compare the outcome of the therapy between centers. This multicenter observational study aims to assess between-center variation in functional outcome of ADHD patients one year after the diagnosis, according to the treatment received. We used the Regional ADHD Registry data on 1429 patients enrolled in 16 ADHD centers in the 2011–2022 period. To evaluate the effectiveness of the therapy we used a generalized linear mixed model with the center as the random effect, including patient condition at diagnosis and center characteristics, weighting by the inverse of the propensity score of the treatment received by the patient. Between-center variation was expressed as the relative difference in odds-ratios between the observed and the expected number of patients whose condition improved, using the Clinical Global Impressions—Improvement Scale (CGI-I), and the relative 95% CI. Patients who received combined treatment were significantly more likely to improve compared to other treatment groups (65.5% vs 54.4% for methylphenidate alone, 53.4% for psychological treatment alone, or 40.5% for no therapy). Adjusted for patients and center characteristics, the log-odds ratio ranged from 0.85 (0.29–1.55 95% CI) to − 0.64 (− 1.17–− 0.18 95% CI). The mean expected probability of improvement after one year of therapy for an average patient with ADHD for each center was 47.7% in a center at the 25th percentile and 61.2% in a center at the 75th percentile of the outcome distribution after adjustments. The wide between-center variation in patient functional improvement one year after the diagnosis of ADHD could be largely explained by center-specific therapeutic approaches or attitudes. More careful and stringent work is needed to reduce differences in responses between centers, as could formal and periodic audit programs within and between centers.

ДІЯЛЬНІСТЬ АУДИТОРСЬКИХ ФІРМ В УМОВАХ ВОЄННОГО СТАНУ – ОНЛАЙН-АУДИТИ

The issue of audit development under martial law and post-war reconstruction is currently extremely relevant and plays an important role for both business and the state, which influenced the choice of the topic, stated goal, objectives, subject and structure of the research. As a result of the hostilities and mass migration, the audit industry has suffered serious negative consequences. The legislator has taken significant measures to stabilize the situation and restore the activities of audit entities. A whole range of regulations was adopted to ensure the effective operation of audit firms. In particular, scholars have paid great attention to the issue of online audits. Prominent international organizations of auditors and professional accountants have developed the Guidelines for Ukrainian auditors taking into account the conditions of the military conflict. It turned out to be urgent because business entities that continue to operate in the conflict zone need constant support and advice. The article analyzes the state of audit activity in the context of the military conflict, identifies the main problems and suggests the ways to solve them. The authors also identified the main directions of development of audit entities with a view to achieving European integration, including their regulatory framework. The general scientific and general theoretical methods were used in the work: system analysis - to determine the main research criteria; abstract and logical - to make theoretical generalizations and conclusions about the problems and challenges of audit activity in war conditions; induction - at the stage of collecting, systematizing and processing information for research; deduction - in the process of studying the theoretical problem. The article analyzes the current state and prospects of audit activity and online audit in the context of modern business. The main problems faced by auditors are considered, and the main challenges facing audit firms are identified. Among other things, the positive aspects and future opportunities of online audit were highlighted, and the services that can be provided through this form of audit were considered. The authors found that the issues related to audit activity under martial law were regulated at the legislative level, and the main areas of support for auditors in the post-war period were identified. Prospects for further research consist in the fact that Ukrainian audit firms can achieve further development and recovery in the post-war period with the help of smart management decisions, legislative support, and the introduction of online audits. The priority goal of the audit system should be to increase trust in the audit process and the auditor. This will increase the investment attractiveness of enterprises. Given the uncertainty and riskiness of financial statement users in the current economic environment, the introduction of online audits is a flexible mechanism that will allow receiving audit reports and will influence positive movements in the recovery of the Ukrainian economy, which is why further research is needed.

Dual system of water safety plan auditing in Hungary: benefits and lessons learnt.

A risk-based approach is recognised worldwide as the most reliable means for the provision of safe drinking water. Efficient implementation of the water safety plan (WSP) approach, recommended by the World Health Organization (WHO), is facilitated by an auditing framework. In Hungary, development of WSPs is a legal obligation for water suppliers. WSPs are subject to a two-stage regulatory audit, a consultative central technical audit and a formal local audit. In 2019, a survey was conducted in cooperation with WHO to evaluate audit experiences of over 1,200 WSPs. Recommendations from the central audit significantly improved coherence and compliance of WSPs, confirming the efficiency of the dual approach. The use of a WSP template provided by the national authority further increased consistency and reduced time and work demand of the audit. Both water suppliers and public health authorities indicated a need for further capacity building on WSP development and auditing. The main challenge for water suppliers is the identification and risk assessment of hazards associated with the water source and distribution within premises. The recast European Union drinking water regulation is expected to accelerate the uptake of WSP and strengthen linkages to water catchment management and water safety in buildings.

Alanine/EPR dosimetry for mailed intercomparison at ocular proton therapy facilities-preliminary results for three centres for irradaitions at CCB IFJ PAN eyeline.

Quality control of therapeutic photon beams in the form of postal dose audits based on passive dosemeters is widely used in photon radiotherapy. On the other hand, no standardised dosimetry audit programme for proton centres has been established in Europe so far. We evaluated alanine/EPR dosimetry systems developed at the Istituto Superiore di Sanità (Italy), the Hasselt Universiteit (Belgium) and the Henryk Niewodniczanski Institute of Nuclear Physics Polish Academy of Sciences (Poland) for their applicability as a potential tool for routine mailed dose audits of passively scattered therapeutic proton beams. The evaluation was carried out in the form of an intercomparison. Dosemeters were irradiated in the 70MeV proton beam at ocular proton therapy facility in the Cyclotron Centre Bronowice at the Henryk Niewodniczanski Institute of Nuclear Physics Polish Academy of Sciences in Krakow. A very good agreement was found between the dose measured by three laboratories and the delivered dose determined with an ionisation chamber. This, together with the inherent properties of alanine, such as non-destructive readout, tissue equivalence, weak energy dependence, dose rate independence and insignificant fading, makes alanine a good candidate for a dosemeter used in postal auditing in proton ocular radiotherapy.