Q1. What Is an Audit?

Q1. What is an Audit?

It is a quality process in which the current practice is analysed, evaluated and compared to the recommended practice set out by an organisation. It may be a national guideline.. The aim is to improve your current practice so that you can improve safety and ultimately provide better patient care. If there is room for improvement then action should be taken to amend the problem and then audit it again ie do a further audit cycle after the change has been implemented.

Q2. Why do we have Audits?

To carry out an audit is of vital importance since it promotes reflection of your current practice, looking to see if there is any room for improvement, learning from this, implementing change and then checking if an improvement has been made. An audit improves your current practice and offers an excellent opportunity to work in a team with your staff to collect the relevant data and share ideas. Ideally the outcome should be to enhance patient care and safety and also improve work in the pharmacy.

Q3. What criteria are, with regard to audit?

The criteria, in terms of an audit, are the items of care or an aspect of practice that we wish to examine. It is what is being measured or compared to the guidance already provided. This has to be agreed on for the audit to begin. For example, In Patient Supply request forms should be completed fully, legibly, and accurately reflect what is prescribed on the patient’s drug chart.

There should be a focus on one or two criteria which makes data collection more manageable and the introduction of small changes to practice less challenging.

Q4. What standards are, in regards to audit?

It is the target in which you are trying to accomplish. This is usually expressed as a percentage value and is another requirement for an audit and it should be set before starting the audit. 100% of IPS forms received into pharmacy should be completed fully, legibly and accurately reflect what is prescribed on the patient’s drug chart.

However, having a 100% set standard may be ideal but realistically might not be achievable so it may be preferred to use a lower a standard such as 85-90%. Standards should be set with a suitable timescale.

Q5. How many audits are expected from a pharmacist per year?

Ideally two audits per year should be completed by a pharmacist but there is no limit. It depends on your circumstances. One audit could be based on what happens in your area of practice itself. The audit could be based on a problem or objective already identified within the pharmacy setting but it is up to the individual on which audit they wish to progress. A further audit could be multidisciplinary in nature.

Q6. What is the Audit cycle?

The audit cycle is the process you should follow to conduct a successful audit. The steps to the cycle are:

1. Reason for the audit

2. Audit criteria to be measured

3. Standards Set

4. Preparation and Planning

5. Data collection 1

6. Reasons for the Audit

7. Data collection 2

8. Conclusions

This cycle is then repeated when a new problem or objective arises or routinely to ensure standards remain high. An audit completed as part of The Pharmacy Vocational Training scheme normally is only one cycle and so after completing training a further cycle could be undertaken as a further second audit.

Q7. Why should I submit a proforma of my audit to NES?

NHS Education for Scotland (NES) has a group of trained pharmacists with experience in performing and writing up audits. They will be able to offer peer review and feedback on what you written and therefore helping you improve your auditing skills. A written audit can be used to fulfil some of the CPD requirements and can also be utilised as a template for future audits. In addition, keeping audits in a written format allows you to reflect on what you have set out to improve and whether or not that has been accomplished.

Q8. Where can you download an Audit proforma for submission?

This can be found and downloaded on the NES Pharmacy website CPD pages here.

Q9. Where do you send and submit a completed Audit proforma to?

Your submission form should be emailed to It normally takes about 4 weeks to receive feedback (depending on the time of year). In the Summer months or over Christmas the interval for receiving feedback will be about 6 weeks.

Q10. What should be excluded and included in an Audit submission?

All information in an Audit should be anonymised. There should be no patient details, names of staff or names of organisations involved in the event. Use codenames such as ‘Patient X’, ‘Mr A’ or ‘Pharmacist Y’. Do include as much detail as you can. Set the scene, describe the situation and detail your reflections as to why you started this audit. Remember that the individual reviewing the submission and providing feedback may not be from your area of practice. It is important to describe the event in sufficient detail and to address the key areas:

1. Reason for the audit

2. Audit criteria to be measured

3. Standards Set

4. Preparation and Planning

5. Data collection 1

6. Reasons for the Audit

7. Data collection 2

8. Conclusions

Look at the form that the peer reviewer will use to ensure you know what information they require. The form can be found on the Audit page of the NES Pharmacy website.

To make it easier for the peer reviewers to assess your submitted Audit proforma ensure that:

• There is clear reasoning on why this audit was chosen and if there have been any amendments to the reasoning for the audit after collecting the first set of data.
• The criteria to be measured and standards set should be made clear
• Includes those who were involved or assisted you in the audit, how the data was identified and analysed.
• The data collected should be displayed in labelled tables or graphs (depending on which would be more appropriate). The data from the 1st collection should be compared to the data from the 2nd collection.

These details allow the peer reviewers to give fair and robust feedback.

Q11. Where can I find the Feedback form that will be used by the reviewers?

The form is on the NES Pharmacy website pages under CPD. It can also be found and downloaded here. It is important for the peer reviewer to provide as honest feedback as possible. If they wish further information they will raise the issue as a question for consideration by the author. By doing this the idea is that the author will reflect on the questions asked and therefore address such issues in a future audit.

Q12. What happens to my audit when I submit it for review?

After the Audit proforma has been submitted to NES Pharmacy, it is anonymised and e-mailed to trained external peer reviewers. The reviewers then provide written feedback, utilising the feedback form which can be found on the NES website. The feedback is then collated centrally by NES and developed into a feedback letter. The feedback fetter is then e mailed to the individual who submitted the audit proforma. The feedback provided has to be constructive to help promote learning and reflection.

References

1. NHS Education for Scotland (NES) website Last accessed on the 12/02/2014
2. AAH webpage on Clinical Audit Last accessed on the 12/02/2014
3. Pharmaceutical Services Negotiating Committee (PSNC) Contract Workbook, A Guide to Clinical Audit – Appendix 7 , June 2008 Last accessed on the 12/02/2014
4. Scottish Intercollegiate Guideline Network (SIGN): Sign Audit Tools Last accessed on the 12/02/2014

1 | Page