Clinical Audit on Compliances with the Standard Treatment Guidelines among Patients Diagnosed with Dengue fever in a Tertiary Care Teaching Hospital, Karnataka, South India - A Quality Improvement Project.

Dr.Prasad M.C; Dr.Sathish Raju N; Dr.Subhash Chandra BJ; Dr.Ashok P; Dr.Jyotsna A S.

Volume : VIII, Issue : VII, July - 2019

Clinical Audit on Compliances with the Standard Treatment Guidelines among Patients Diagnosed with Dengue fever in a Tertiary Care Teaching Hospital, Karnataka, South India - A Quality Improvement Project.

Dr. Prasad M. C, Dr. Sathish Raju N, Dr. Subhash Chandra Bj, Dr. Ashok P, Dr. Jyotsna A S.

Abstract :

Background: – Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. Audits and quality improvement projects are vital aspects of clinical governance and continual service improvements in medicine. Dengue is a vector borne viral disease which occurs in tropical and sub – tropical regions around the world. Clinical audit aims to identify the gaps between established norms and practiced norms. Herein, we present 51 cases from more recent clinical experience that demonstrate the adherence of Platelet transfusion and Fluid replacement therapy against dengue virus infection to the set standards. Aim & Objectives:– To improve the care of patients presenting with dengue fever at various stages and to Evaluate the Adherences to Standard Treatment Guidelines among Patients Diagnosed with Dengue fever. Methods: – Retrospective observational study was undertaken among adult patients in a tertiary care teaching hospital. Fifty one patient�s case records were studied and analysed. All patients who were NS1 antigen / IgM dengue positive were included in the study. Clinical features, hematological and biochemical parameters were noted. Paediatric patients were excluded from the study. Results:– Out of 51 patients 29 were NS1Ag positive. 24 patients were in dengue fever without any critical signs. 9 each were in DHFI and DHFII. 4 were in DHF III. 5 were in DHFIV. 4 out 9 DHFI grade did not received adequate fluids and 3 out of 9 in DHF II did not received adequate fluids. All DHFIII, DHFIV patients were managed as per guidelines. Platelets transfusion done for all 5 patient with stage DHFIV Conclusion: – Clinical audit is a quality improvement process that measures current patient care and outcomes against agreed standards of best practice. Diagnosis of the illness and grading the severity of the illness is as per Indian national guidelines for dengue. So effectively 7 out of 51(13.68%) patients did not receive fluids therapy as per Indian National Dengue Guidelines. Audits and quality improvement projects are vital aspects of clinical governance and continual service improvement in medicine.