Ray S, De Cock R, Mahari M, Chiposi M L
Department of Community Medicine, University of Zimbabwe Medical School, Harare.
Cent Afr J Med. 1995 Dec;41(12):385-91.
Clinical audit was performed on the accuracy of malaria diagnosis by nursing staff within Harare City Health Department using diagnosis by doctors as the reference standard. This was found to be about 10 pc based on symptoms. The criteria for diagnosis of malaria as in ZEDAP manuals and in-house training were not being utilised. Pyrexia was not present in 40 pc of the patients. Serious illnesses were occasionally dismissed as malaria and not treated appropriately or reviewed. The most common misdiagnosis was of acute respiratory tract infections which also have clear guidelines for diagnosis. More appropriate training methods need to be developed to improve the diagnostic capacity of nursing staff who are frontline providers of primary health care. This study shows the importance of performing an audit for process evaluation, compared to set standards and to be used for improving the quality of services.
以医生的诊断为参考标准，对哈拉雷市卫生部门护理人员疟疾诊断的准确性进行了临床审计。基于症状，发现这一准确率约为10%。《津巴布韦消灭疟疾和加强疟疾防治计划》手册及内部培训中规定的疟疾诊断标准未得到应用。40%的患者没有发热症状。严重疾病偶尔被误诊为疟疾，未得到适当治疗或复查。最常见的误诊是急性呼吸道感染，而急性呼吸道感染也有明确的诊断指南。需要开发更合适的培训方法，以提高作为初级卫生保健一线提供者的护理人员的诊断能力。本研究表明，与既定标准相比，进行过程评估审计对于提高服务质量具有重要意义。
