Lee L, Girish S, van den Berg E, Leaf A
Neonatal Unit, University Hospital of North Staffordshire, Stoke-on-Trent, UK.
Arch Dis Child Fetal Neonatal Ed. 2009 Mar;94(2):F116-9. doi: 10.1136/adc.2007.131052. Epub 2008 Aug 1.
Random safety audits have been shown to be effective in improving standards of practice in high-risk industries. They are process audits rapidly performed during real-time clinical activity, with immediate feedback, allowing for immediate change of practice.
Based on a concept described by the Vermont-Oxford Network, we aimed to introduce random safety audits to our unit to improve infection control and routine neonatal care.
We designed simple data collection tables to audit 11 infection control and four routine care standards. Audits were undertaken during the weekly grand round. Immediate feedback was given.
In 6 months we completed three cycles of 15 audits each. Complete results were available for 14 audits. The compliance with the infection control standards improved from a median of 70% (range 20%-100%) to 95% (range 66%-100%). The results of the routine care standards were more variable.
We have shown that this innovative method of random safety audits is effective in quickly improving practice. We believe this to be due to the instant feedback, continued emphasis on infection control and good clinical practice, and improved teamwork.
