Frequent Audits Research Articles

Unveiling Transparency: A Deep Dive into the Audit Committee's Role in Enhancing Financial Performance of Quoted Manufacturing Companies in Nigeria

This research looks at the critical role that audit committees play in improving the financial performance of Nigerian-listed manufacturing companies. The study, which spans the years 2014 to 2023, looks at how audit committee features, such as meeting frequency, size, and gender diversity, affect financial measures including Return on Capital Employed (ROCE), Return on Equity (ROE), and Profit before Interest and Tax. The research takes a quantitative approach, analyzing data from ten chosen manufacturing companies listed on the Nigerian Stock Exchange. The data demonstrate that more frequent audit committee meetings and bigger committee sizes are positively related to superior financial performance. Still, more gender diversity reveals a complicated connection that warrants additional investigation. The report emphasizes the need for strong corporate governance standards; in particular, the membership and actions of audit committees play an important role in promoting financial openness and investor trust. These findings offer useful information to policymakers, corporate stakeholders, and governance authorities looking to improve the efficacy of audit committees in the manufacturing sector.

Safeguarding Taxpayer Data

The Internal Revenue Service (IRS) collects more information on more individuals than any other government agency. The information is not only financial but personal, potentially including information about health care needs and decisions; the caregivers, disabilities and foreign birth of children; the educational progress and felony convictions of students; and one’s religious and charitable associations. In acknowledging the vast quantity of information held by the IRS, and the necessity of taxpayers trusting tax administrators with their information, Congress provided greater protection for taxpayer information under the Internal Revenue Code (IRC) than it was provided under the Privacy Act. Congress obligated IRS employees to keep taxpayer information confidential, and authorized felony charges and damages suits, including punitive damages for inappropriate disclosures of taxpayer information. These special protections were enacted almost 50 years ago, long before the spread of the internet and emergence of cybercrime. This Article proposes updating the IRC’s special protections for taxpayer information to reflect the cybersecurity objectives of the Federal Information Security Modernization Act (FISMA), and the frequent audits of the IRS by its Inspector General that show the IRS’s persistent failures to comply with FISMA guidance, such as failing to encrypt taxpayer data, secure mainframe platforms, regulate system access, remediate known vulnerabilities and assist victims of data breaches.

Effect of Tax Audit on Turnover Tax Compliance among Small and Medium Enterprises in Langata Sub-County, Nairobi, Kenya

Purpose: The implementation of turnover tax compliance (TOT) in Kenya was aimed at enhancing revenue collection and improvements in the tax system, the effectiveness of tax administration, and lowering the collection costs in the SME sector. However, over the past decade, the KRA has visibly struggled to implement the tax regime as well as collecting the returns. One of the major shortfalls of the TOT has been its collection due to its dependence on the goodwill among the affected taxpayers. Therefore, the main aim of the study was to establish the effect of tax audit on turnover tax compliance among small and medium enterprises in Langata sub-county, Nairobi, Kenya. The study was anchored on the Economic Deterrence theory. Methods: The study adopted an explanatory research design. The sample size for this study was 353 derived from 3,061 registered SMEs of the population using Yamane (2012) formulae and the responses by owners/managers of the firms. The study targeted 353 questionnaires with each target firm, 268 respondents managed to fill and return the questionnaires showing a 76% response rate. Results: The analysis of the hierarchical model found that tax audit has a significant positive effect on TOT compliance (B = 0.373, p = 0.006). In a nutshell, the study found that there is a significant relationship between tax audit and TOT compliance among small and medium enterprises in Langata Sub County, Nairobi, Kenya. Conclusion: The study recommends conducting frequent tax audits to enhance Turnover tax compliance.

The Influence of Loan to Deposit Ratio (LDR) and Operating Costs on Operating Income (BOPO) on Return on Assets (ROA)

This study examines the influence of LDR and BOPO on ROA at a bank in Bandung. Return on Assets (ROA) highlights the Company's ability to produce revenue from its operations by efficiently using its assets. Factors affecting Return on Assets (ROA) encompass the Loan to Deposit Ratio (LDR) and the Operating Expenses to Operating Income Ratio (BOPO), all of which impact ROA. The study's population consisted of four years of financial records from a bank in Bandung, encompassing all four quarters. The sample was selected using the time series approach, consisting of 16 financial reports from 2018 to 2021. The applied data testing method was multiple linear regression, utilizing a significance level of 5% alpha. The findings indicated that LDR did not exert a significant influence on ROA. Despite LDR exhibiting a positive coefficient, the significance value is above the conventional threshold, suggesting that the impact of LDR on ROA is minimal and statistically insignificant. Conversely, BOPO substantially impacts ROA, with a negative coefficient and a minimal significance value. The rise in BOPO, signifying diminished operational efficiency, adversely affects ROA, suggesting that elevated operating costs diminish the bank's profitability. Subsequent research indicated that the regression model accounts for most of the variation in ROA, demonstrating a robust association between LDR and BOPO with ROA. It is advised that the Company's management concentrate on optimizing operating cost management to enhance ROA. Implementable strategies encompass conducting frequent audits to identify and mitigate waste and enhancing the efficiency of operational procedures. Despite LDR not demonstrating a significant impact, it is crucial to monitor this ratio to ensure the bank's liquidity and financial stability. This study also advocates for additional research to investigate other variables that may influence ROA, along with a comprehensive examination of operational elements to enhance profitability.

Transforming Supplier Audits with AI: A Risk-Based Approach in Medical Devices

The medical device industry, highly regulated and sensitive to quality standards, relies on rigorous supplier audits to ensure compliance and mitigate risks. However, traditional supplier audits are often resource-intensive, inconsistent in quality, and lack a clear focus on the most critical risk factors. This paper explores how Artificial Intelligence (AI) can revolutionize the supplier audit process by enabling a risk-based approach that enhances accuracy, efficiency, and regulatory compliance. AI technology, with its advanced data processing, predictive analytics, and machine learning capabilities, can analyze vast amounts of supplier data in real-time, generating risk scores that prioritize high-risk suppliers for more frequent and thorough audits. This shift allows medical device companies to better allocate resources, focusing on high-impact areas and enhancing overall supply chain security. By considering factors such as supplier compliance history, product criticality, regional compliance laws, and performance trends, AI provides a dynamic and data-driven assessment model that minimizes the reliance on subjective audit practices. The paper introduces an AI-powered risk-based audit framework specifically tailored for medical device companies. This framework utilizes a multi-faceted AI-driven risk scorecard, categorizing suppliers by risk levels (high, medium, low) and enabling targeted audit strategies. It also demonstrates how AI can process a wide array of audit-related data inputs—such as supplier compliance, regional geopolitical risks, supply volume, and product criticality—to generate a holistic and accurate risk assessment. Through case studies and industry examples, this research underscores the advantages of integrating AI into supplier audit processes, highlighting cost savings, improved compliance outcomes, and reduced risk of quality issues or product recalls. Furthermore, it examines future trends and ethical considerations of AI in supplier audits, advocating for industry-wide adoption of AI-powered tools to support more efficient and effective supplier management. This paper concludes that adopting a risk-based, AI-driven audit approach in the medical device sector not only supports regulatory compliance but also builds resilience within the supply chain, creating a safer and more efficient landscape for medical device production.

An Efficient Multilayer approach for Securing E-Healthcare Data in Cloud using Crypto – Stego Technique

Healthcare data has been moving to cloud platforms in recent years, which has increased accessibility and scalability but also raised security issues. Ensuring data integrity and safeguarding private health information from unwanted access are critical. This paper presents a comprehensive strategy to integrate effective Elliptic Curve Cryptography ECC-AES with steganography techniques to improve the security of healthcare data in the cloud. ECCAES is especially well-suited for cloud situations with limited resources since it provides strong security with reduced key sizes. Confidentiality is guaranteed by encrypting healthcare data using ECC- AES before storage, reducing the possibility of data breaches. Steganography techniques are also integrated to improve security against skilled adversaries by adding an extra degree of obfuscation by concealing encrypted data inside innocuous files or images. Strict key management procedures, access control systems, and frequent security audits are important components of the proposed system that ensure adherence to Health Insurance Portability and Accountability Act (HIPAA) and General Data Protection Regulation (GDPR) compliance requirements pertaining to healthcare data protection. Programs for employee awareness and training are also crucial for reducing the likelihood of human mistakes. Healthcare businesses can safely use cloud technology while protecting patient data integrity and privacy by putting in place multi-layered security safeguards. The proposed system provides the multilayer security on healthcare data in cloud environment than other existing systems.

Diversity Audit at Starbucks: Assessment of Workforce Demography, Inclusion Initiatives, and Corporate Culture

The main goal of this diversity audit is to evaluate Starbucks’ present diversity and inclusion programs for efficacy. This audit evaluates organizational policies, worker satisfaction, workforce inclusionary practices, and the results of diversity programs at two Starbucks locations. The audit uses a mixed-methods approach, combining the analysis of publicly available data and direct observational studies, in South Florida locations, to provide a comprehensive knowledge of Starbucks’ diversity policy. The findings demonstrate a noteworthy level of gender diversity and highlight areas in which minority representation in senior management roles needs to be strengthened. Creating employee resource groups, stepping up diversity training, using targeted recruitment techniques, and conducting frequent diversity audits to guarantee ongoing improvement are just a few of the recommendations. The paper provides actionable insights to help firms like Starbucks maintain a competitive edge in a diversified global market and enhance their inclusivity. The advancement of an inclusive culture that recognizes and benefits from diversity at all organizational levels depends on many measures that are tracked and improved consistently. By implementing practical suggestions, modern organizations can ensure that their diversity initiatives stay relevant and successful, upholding their standing as pioneers in corporate diversity programs. In addition to assisting Starbucks in navigating a challenging international market, a proactive commitment to diversity and inclusion will help create a more just society. In a culturally diverse work environment, a diversity audit is a crucial tool for corporations to assess and improve their workforce equity, accessibility to everyone, and inclusivity. By conducting a thorough review of existing policies, practices, and employee experiences, diversity audits help identify biases, barriers, and areas for growth before any costly lawsuits surface. This process enables companies to pinpoint disparities in hiring, promotion, and retention rates, as well as uncover hidden biases in decision-making processes. With audit findings, corporations can develop targeted strategies to foster a more inclusive culture, enhance employee engagement, and boost innovation. Ultimately, a diversity audit helps organizations ensure fairness, equity, and equal opportunities for all prospects and employees, thereby leading to increased productivity, better brand reputation, and a competitive advantage in both attracting and retaining diverse top talent for the firm.

An Analysis of Managing the Cloud: Obstacles and Solutions for Efficient Administration and Protection

Cloud management offers possibilities and difficulties to enterprises looking for effective management and strong data security. This essay examines the challenges associated with cloud administration and suggests workarounds for these issues. Assuring data security, upholding legal compliance, cutting expenses, and overseeing intricate multi-cloud setups are important obstacles. The use of cloud-native monitoring and governance tools, the implementation of extensive data backup and recovery plans, the use of automation for resource provisioning and administration, and the implementation of strong security measures like encryption and access restrictions are all necessary for finding solutions. Organizations may improve the security of their important data assets and expedite their cloud administration procedures by tackling these challenges with suitable solutions. Ensuring data security is a major concern in cloud administration. Organizations are concerned about data breaches, illegal access, and industry regulatory compliance when they move critical data to the cloud. Organizations need to have strong security mechanisms like identity management, access restrictions, and encryption in place to lessen these risks. Furthermore, implementing a defense-in-depth strategy that incorporates several security tiers might improve cloud environments' overall resilience. Upholding legal requirements and industry norms is another challenge for cloud managers. To secure sensitive data and uphold client confidence, businesses in regulated sectors like healthcare and finance are subject to strict compliance regulations. Adherence to frameworks like HIPAA, GDPR, and PCI DSS, as well as thorough policies and frequent audits are necessary to achieve compliance in the cloud. Organizations may minimize the risk of non-compliance penalties and expedite compliance processes by putting governance tools and compliance automation systems into place. For enterprises using cloud resources, cost optimization is another major concern. Pay-as-you-go cloud services might result in overspending and financial restrictions due to improper resource utilization.

Patient voices and student insights into LGBTQ+ healthcare: a call for equitable healthcare through medical education

ABSTRACT Purpose Lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse (LGBTQ+) individuals have health needs specific to their identities. However, they face discrimination and cis-heteronormativity in most patient-provider interactions, which often translate into poor healthcare. Evidence suggests doctors are inadequately trained to care for LGBTQ+ patients. Medical students are well-placed as the future workforce to establish affirming behaviours. This study garners LGBTQ+ patients’ healthcare experiences, where limited qualitative evidence exists, and explores whether students have insight into these experiences. Method Thirty LGBTQ+ patients and twenty students, evenly divided between Singapore and the United Kingdom (UK), two legally and culturally different countries, consented to semi-structured interviews in 2022 to evaluate their LGBTQ+ healthcare perceptions. Thematic analysis was conducted using a collaborative, iterative process involving five investigators, with frequent auditing of data interpretation. Results Most patients described implicit biases with a lack of support and professionalism from doctors, hindering health outcomes. Patients experienced misgendering and a lack of recognition of sexual and gender diversity; students appreciated the need to acknowledge patient identity. Although perceptions surrounding certain themes were similar between patients and students in both countries, patients’ voices on the complexity and dissatisfaction of gender-diverse care contrasted with students’ lack of insight on these themes. Singapore patients were more concerned with sociolegal acceptance affecting health needs, whilst UK patients noted more nuanced barriers to healthcare. Although many students were unsure about specific health needs and perceived a lack of training, they expressed willingness to create an equitable healthcare environment. Conclusions LGBTQ+ patients provided powerful narratives on discrimination surrounding their healthcare needs. To address these, medical students must be encouraged by healthcare educators to develop identity-affirming behaviours as future change-makers and challenge cis-heteronormative views. Alongside vital institutional changes tailored to each country, patients’ and students’ collective action would create meaningful educational opportunities to reach culture change.

Determinants and Extent of Tax Compliance among SMEs in Arusha City Council, Tanzania

Taxes have been a nourishing commodity in generating revenues liable for financing governments’ budgets all over the world. This being the fact, this study examined the determinants and extent of tax compliance in SMEs in Arusha City Council which was the specific objective of this study. This was a cross-sectional study which employed a double Hurdle regression model to analyze primary data collected from a sample of 100 SMEs’ owners obtained by simple random sampling to represent the entire population of SMEs owners via questionnaire and analyzed with STATA software version 17. Using the economic deterrence theory to guide the analysis of this study, the analysis found that Male entrepreneurs dominate the SME sector, SME owners understand tax regulations and undergo frequent tax audits. Further, the findings revealed that privately owned SMEs, primarily ran by persons in their mid-30s are flexible with an average workforce of nine employees. Furthermore, SMEs were found to generate feasible profits and fulfill tax compulsions by paying an average tax rate. Moreover, the double hurdle regression model shown that age and profits have negative effect on tax payments, and higher household size of SMEs owners are associated with higher tax payments. Additionally, publicly owned enterprises positively comply with tax. Therefore, given these findings, this study recommends to policymakers to streamline tax procedures and develop a platform to discuss tax rates with tax payers before implementing the planned tax obligations.

A prospective registry study of the epidemiology and management of childhood cancer in the Gambia-The first year experience.

Globally, over 180,000 children develop cancers yearly, with about 80% residing in low- or middle-income countries where cancer-associated mortality is also high. In The Gambia, cumulative incidence rate of 27.6 childhood cancers/million population was reported between 2002 and 2011. The current study appraised newly-established pediatric oncological services in The Gambia. In this prospective registry study, children with cancer who presented at the pediatric units, Edward Francis Small Teaching Hospital, Banjul, between November 2022 and October 2023 were assessed. Data on sociodemographic variables, mode of admission and presentation, tumor type, diagnostic methods, and challenges such as laboratory support, treatment, use of blood/blood products; and eventual outcome were analyzed. The median (interquartile range, IQR) age at presentation of the 44 children was 36.0 (22.3-117.0) months. Wilms tumor was the most common tumor 12 (27.3%); followed by leukemia 11 (25.0%); germ cell tumor 8 (18.2%); lymphoma 6 (13.6%); retinoblastoma 4 (9.1%); rhabdomyosarcoma 2 (4.5%) and one central nervous system tumor (2.3%). The median(IQR) duration of symptoms before presentation was 48 (21-90) days, presentation to diagnosis 7.5 (3-20.8) days, and first symptom to diagnosis 62.5 (32-126.8) days. Treatment refusal and abandonment rates were 20.5% and 13.6%, respectively. Families of 93.8% of children could not procure cytotoxic drugs due to nonavailability, high cost, or both. Adequate laboratory monitoring was only available in 6.8%, and none had platelet concentrate transfusion or radiotherapy. The nine (20.5%) who completed treatment are currently being followed up, 10(22.7%) are still receiving chemotherapy, while 2(4.5%) were referred. Eight (18.2%) died, predominantly from metastasis (75%) and severe drug toxicities (25%). Late presentation and diagnosis, poverty, unavailability of drugs, suboptimal or lack of laboratory testing, blood product, adjuvant medications, and psychosocial supports contributed to high treatment refusal, abandonment, and mortality. These daunting challenges can be ameliorated with regular community sensitization, frequent cancer auditing, and strong political will.

Potentially Inappropriate Medications in Hospitalized Older Patients in Tabuk, Saudi Arabia Using 2023 Beers Criteria: A Retrospective Multi-Centric Study.

Older persons are frequently prescribed several medications; therefore, inappropriate medication prescriptions are common. Prescribing potentially inappropriate medications (PIMs) poses a serious risk and hence, we aimed to assess the PIMs in older patients in Tabuk, using the 2023 Beers criteria. A retrospective cross-sectional study was carried out, including older persons ≥65 years of age admitted in two government hospitals from June 2022 to May 2023, and prescribed with five or more medications. PIMs were assessed using the 2023 Beers criteria. Descriptive analysis was performed for the categorical and continuous variables. Logistic regression was used to assess the influence of age, gender, number of medications and comorbidities on PIMs using SPSS version 27. The study included 420 patients. The mean age of the participants was 75.52 ± 8.70 years (range, 65-105 years). There was a slightly higher proportion of females (52%). The prevalence of PIMs was 81.43%, where 35.41% were prescribed one PIM, 26.48% were prescribed two PIMs, and 17.32% were prescribed three PIMs. The proportion of medications considered potentially inappropriate among older patients was 70.11%, and proton pump inhibitors were the most commonly prescribed medication (52.99%). The proportion of medications to be used with caution was 19.55%, with diuretics being the most frequently administered medication (91.43%). Gender and comorbidity did not influence PIMs, but age and number of medications significantly influenced the likelihood of PIMs. PIMs are prevalent among older people and are significantly associated with age and multiple medications. Caution should be exercised while prescribing medications to older persons. Frequent audits should be performed to assess PIMs, and clinicians should be informed of the same to avoid serious outcomes associated with PIMs. Interventions designed to reduce PIM need to be initiated.

CRABEL Score Assessment for Oral Surgery Excision Biopsy Case Notes of Oral Squamous Cell Carcinoma.

Background Oral surgical records contain all the information regarding a patient, including their history, clinical findings, diagnostic test results, pre-and postoperative care, progress, and medication. Notes that are properly drafted will help the physician argue that the course of therapy is appropriate. Several tools have been created for auditing clinical records; one such tool that may be used for any inpatient specialty is the CRABEL score system developed by CRAwford-BEresford-Lafferty. Aims This research aimed to evaluate the oral surgical records using the CRABEL scoring system for quality assessment. Materials and methods The case audit was performed from June 2023 to February 2024 for all Excisional biopsy cases of Oral Squamous Cell Carcinoma. Relevant data was retrieved from the Dental Information Archival Software (DIAS) of Saveetha Dental College and Hospitals, Chennai. It was evaluated by two independent oral pathologists trained in CRABEL scores. Two consecutive case records were evaluated. Fifty points were given for each case record. Scoring was given according to initial clerking (10 points), subsequent entries (30 points), consent (5 points), and discharge summary (5 points). The total score was calculated by subtracting the total deduction from 100 to give the final score. The mean scores of the case records were calculated. A descriptive statistical analysis was done with Statistical Package for Social Sciences (SPSS version 23.0; IBM Inc., Armonk, New York). Inter-observer agreement and reliability assessment were made using Kappa statistics. Results From the DIAS in that period, the data of 52 cases were retrieved and reviewed. There was no proof of a reference source in the audited records, and one deduction was made to the reference score in the initial clerking, and the effective score was 98 out of 100. The mean values of 52 case records were also 98 out of 100. The observed kappa score was 1.0. There was no inter-observer bias in the scoring criteria. Both observers also gave the same scoring. Conclusion Our study illustrates that oral surgery case records in our institution were found to be accurate, as they maintained 98% of the CRABEL score value. Frequent audit cycles will help in standardizing and maintaining the quality of oral surgery case records.

Lessons learnt from the construction and implementation of a prospective ventral hernia database.

The New England VA Hernia Registry was created in 2011 to prospectively collect relevant details of ventral hernia repairs, with the intention to assess and improve long term outcomes. The goal of this study is to assess registry compliance. All ventral hernia operations performed in five VA hospitals between 2011-2022 were obtained. We assessed compliance at the hospital and surgeon level. 3,516 cases were performed. Overall compliance with registry entry was 37.5%, ranging from 10.8% to 67.2% across hospitals. At the hospital level, there was a negative correlation between average yearly hernia volume per surgeon and registry compliance (r2 = 0.53). Surgeon compliance varied within hospitals and over time. Registry compliance was low and highly variable. Lack of interest, incentives, oversight, and surgeon turnover are possible factors for noncompliance. Building a registry with these factors in mind, providing timely feedback, and conducting frequent audits may improve compliance.

Improving medical record completeness at Wallaga University Referral Hospital: a multidimensional quality improvement project

BackgroundAppropriately documented medical records enhance coordination, patient outcomes and clinical research.ObjectiveThe aim of this project was to improve Wallaga University Referral Hospital’s (WURH) medical record completeness rate from 53% to...

Leveraging Technology for Government Service Delivery: Suggestions for Securing the e-Citizen Service in Kenya

Governments across the world have increasingly embraced e-governance in the provision of public services. This development has significantly reduced bureaucracy, enhanced efficiency, reduced corruption and fundamentally transformed public service delivery. However, the adoption of these copyright technology solutions, owned by international corporations and non-state actors, mostly multinational corporations (MNCs), have equally exposed user governments, such as Kenya, to significant cyberspace security threats, service disruptions and exposed national security leading to interferences in national autonomy and at times threatened national sovereignty. The threats arise from the activities of offensive states, malicious non-state actors and individuals taking advantage of the integrated and dependent internet connectivity networks. This paper is an extract from a study conducted on Information Security Threats to e-Citizen services in Kenya. The research presents findings on the effectiveness of information security measures initiated to secure the e-Citizen services in Kenya. The case study adopted a mixed method design combining cross-sectional and descriptive research design that targeted 12,000 respondents (users) from 51 Huduma Centres countrywide. Purposive sampling was applied to select 10 Huduma centres and 10% of respondents from each of the selected centres. About 1,200 questionnaires were issued with a return rate of 80% which translates to 966 responses. The study applied both quantitative and qualitative techniques in analysis. The study identified 10 categories of security measures which are discussed in this paper categorized under legislation and policy; infrastructure and capacity development; protective action; monitoring and oversight. From the findings, Kenya has implemented the measures of information security to a satisfactory level even though more is needed in terms of engaging the populace to enhance safe data use, handling and storage. In order to bolster a safe service delivery e-Citizen system, the study recommends locally modelled technological solutions, mutually beneficial cyber security collaborations, frequent infrastructure security audits, user capacity training and restructuring national security organs to create cyberspace manning capabilities. These sectoral changes will enhance preventive, defensive and offensive capabilities against arising cyberspace threats from geopolitical, technological, economic and security competition and rivalries among global nations, non-state actors and malicious individuals

Examining Potential Threats of Eavesdropping in TCP Stream of Personal Interactive Transmission Session

This study establishes that Personal Interactive Transmission Sessions conducted using TCP streams provide exceptional convenience and immediacy. However, they also provide noteworthy challenges and considerations, especially in terms of security, integrity, and performance. This study investigates the security weaknesses present in potential eavesdropping threats on TCP Streams during personal interactive transmission sessions. An experimental analysis was carried out, by doing a comprehensive analysis of network traffic using Wireshark. The investigation reveals a notable vulnerability in the management of user-provided data, together with the possible risks of eavesdropping, emphasizing the urgent need for enhanced security measures. The findings underscore the need of proactive cybersecurity strategies, such as frequent security audits, vulnerability assessments, and the implementation of robust encryption methods, to safeguard user privacy and ensure data integrity. To enhance risk mitigation, data protection, and user confidence in the digital environment, organizations should prioritize addressing potential eavesdropping threats during transmission sessions that involve sensitive personal data.

Pain-free hospital implementation: a multidimensional intervention to improve pain management at Wallaga University Referral Hospital, Nekemte, Ethiopia

ObjectiveThis quality improvement project is aimed to increase pain free hospital implementation from 21.7 to 80% at Wallaga University Referral Hospital (WURH) from January 1, 2023 to June 30, 2023.MethodsHospital based interventional study was conducted at WURH. The Plan- Do-Study-Act (PDSA) cycle was used to test change ideas. A fishbone diagram and a driver diagram were used to identify root causes and address them. Major interventions included training of health professionals, initiation of pain as fifth vital sign, policy and protocol development, and conducting regular supportive supervision.ResultsUpon completion of the project, overall pain-free hospital implementation increased from baseline 21.7–88.7%. Implementation of pain as 5th the vital sign was increased from 15.4 to 92.3%. Regular audits of pain assessment and management increased from 27.3 to 81.8%. Two standardized treatment protocols or chronic and acute pains were developed from baseline zero. A focal person for Pain-free hospital implementation was assigned. More than 85% of healthcare providers were trained in pain assessment and management.ConclusionCompliance with pain-free hospital implementations was significantly improved in the study area. This was achieved through the application of multidimensional change ideas related to health professionals, standardized guidelines and protocols, supplies, and leadership. Therefore, we recommend providing regular technical updates & conducting a frequent clinical audit on pain management.

Time to Revisit Audit Committee Activity: Evidence from Audit Adjustments

ABSTRACT This study examines the impact of audit committee activity on audit adjustments. Using unique Korean data on audit adjustments—the earnings discrepancy between pre-audit earnings prepared by management and audited earnings, we find that frequent audit committee meetings decrease the audit adjustments made by external auditors. However, the effectiveness of audit committee activities declines as the number of meetings increases. Additionally, the findings are more pronounced for firms appointing audit committee chairs with accounting financial expertise. Overall, our study highlights audit committee effectiveness critically depends on its activity and the role of the chair.

Dominant Factors Influencing the Implementation of Safety Protocols in Building Project Sites

Despite establishing extensive safety regulations and protocols, the construction sector finds it challenging to consistently uphold these norms. This study attempts to investigate the dominant factors influencing the implementation of safety protocols with a view to safeguarding the health and safety of workers while reducing the likelihood of accidents and guaranteeing the reliability and durability of built infrastructure. The study employed a cross-sectional research design and Lagos State served as the research area. The population of the study comprised built environment professionals and site operatives who were conveniently selected. The study utilized two sets of structured questionnaires that were self-administered to the two groups of respondents. Descriptive and inferential statistical approaches were employed to analyze the data collected. The findings revealed that the dominant factors influencing the implementation of safety protocols on building project sites among the built industry professionals and site operatives include management support, regulatory requirements, safety awareness, employee training and education, recognition and encouragement, workers’ attitudes, and penalties for non-compliance. The study concludes that regulatory requirement has a profound influence on how safety protocols are being implemented in building project sites. This implies that stringent adherence to regulatory requirements reduces risks and promotes a safety culture, which sustains the safety of building project sites. The study therefore recommends that the management of construction organizations should keep employees abreast of local safety requirements and provide guidelines for its implementation for compliance to be easily incorporated into building site operations. This may be accomplished by maintaining up-to-date information, performing frequent audits, and putting in place robust mechanisms aimed at guaranteeing compliance.