There are many pre-prepared audit templates that can be used to complete a clinical audit once the topic, criteria and standards have been determined.
Audits can be completed using readily available templates or the templates can be adapted to meet the specific criteria of the chosen audit.
The following details some of the currently available audits:
Acute kidney injury / hydration message audit
This audit supports the contribution made by community pharmacy teams in preventing avoidable harm associated with acute kidney injury (AKI).
Dehydration associated with vomiting, diarrhoea, fever or low fluid intake can trigger AKI. The risk of dehydration is highest in older patients.
Patients with a UTI should be given advice on maintaining fluid intake.
The audit involves providing appropriate advice over maintaining a safe level of hydration to patients prescribed antibiotics for a UTI i.e. trimethoprim, nitrofurantoin or pivmecillinam, or patients requesting OTC advice for UTI symptoms.
Data can either be collated using paper forms or entering directly onto PharmOutcomes. It is recommended that the audit is conducted over a 2 week period with a minimum of 15 patients counselled.
Download details of the audit [SPS]
Community Pharmacy NSAID Audit on Gastrointestinal Safety
The gastro-intestinal side effects of NSAIDs is well recognised. This audit only considers gastro-intestinal safety related to NSAIDs. The audit involves reviewing patients prescribed NSAIDs or COX2 inhibitors for more than 2 months to ensure gastro-protection is prescribed, and to provide verbal advice to patients prescribed oral NSAID or COX2 inhibitors whether these are regular medicines or not.
Data can be collated using paper forms or entered directly onto PharmOutcomes. It is recommended that data is collected for approximately 1 week and includes a minimum of 10 patients.
Download details of the audit and data collection tools [NHS]
Asthma audit: LABA bronchodilator as monotherapy for asthma without a corticosteroid inhaler
This audit aims to identify asthmatic patients who have been prescribed a LABA inhaler (e.g. formoterol, salmeterol) for managing their asthma symptoms who have not been prescribed or are not using an inhaled corticosteroid. The audit also reviews the provision of advice to asthmatic patients regarding the importance of regular inhaled corticosteroid use.
This audit supports the implementation a key recommendations of the National Review of Asthma Deaths (NRAD) that “The use of combination inhalers should be encouraged. Where long acting beta agonist (LABA) bronchodilators are prescribed for people with asthma, they should be prescribed with an inhaled corticosteroid in a single combination inhaler”.
Use an inhaled LABA without inhaled corticosteroids has been associated with a worsening of asthma in some patients. Clinical practice generally considers that combination inhalers aid adherence and guarantee that the LABA is not used without the inhaled corticosteroid.
Download details of the audit and data collection forms [PSNC]
Stop smoking services
The RPS provides a range of resources and tools to support pharmacy contractors wishing to audit different areas of their smoking cessation service from initial recruitment of patients to successful quit attempts. The resources can be used to compare individual services with existing standards and identify areas of underperformance. The resources can be freely amended to suit the specific criteria of the chosen audit.
Download resources [RPS - members only]
Asthma audit toolkit
Many patients with asthma do not have adequate control of their symptoms. The RPS asthma audit toolkit provides resources to enable pharmacy contractors to audit the services they provide to asthma patients including patient counselling, adherence, confirmation of patient understanding and smoking cessation advice.
Download resources [RPS members only]
Owings and out of stock items
Auditing the availability of medicines for supply to patients is a direct measure of the level of service provided by a pharmacy. The RPS toolkit provides a selection of resources for auditing the supply of medicines to patients.
Download resources [RPS members only]
Owings audit summary and data collection tools are also available to download from Hampshire and Isle of Wight LPC.
Download resources [Hampshire and Isle of Wight LPC]
Waste medicines audit
Waste medicines is a significant cost to the NHS including the cost of the medicines, the cost of waste disposal and the ongoing health costs associated with deterioration of the patient’s medical condition.
Reducing medicines waste not only reduces the financial burden to the NHS but also improves patient outcomes.
Pharmacists are contractually obliged to accept and dispose of waste medicines and are consequently ideally placed to investigate the scale of the issue and assist with work to reduce the problem.
The RPS waste medicines toolkit provides a selection of tools to support the auditing of waste medicines.
Access the toolkit [RPS members only]
Waste medicines audit summary and data collection tools are also available to download from Hampshire and Isle of Wight LPC.
Download resources [Hampshire and Isle of Wight LPC]
Community Pharmacy asthma audit
BTS/ SIGN guidance follows a stepwise process for the treatment of asthma. Poor inhaler technique or compliance can lead to overprescribing in order to control symptoms.
This audit aims to ensure:
- All asthma patients prescribed an inhaler are able to use it correctly,
- Patients understand why it’s important to use their inhalers as prescribed
- Patient’s asthma is well controlled
It is recommended that data is collected for approximately 4 weeks and includes a minimum of 10 patients.
Download audit specification and data collection tools [NHS]
Concordance with statin therapy
This audit reviews patient understanding of why they have been prescribed a statin, how the statin acts to reduce cholesterol levels and also how statins should be taken.
Statin therapy audit summary and data collection tools are available to download from Hampshire and Isle of Wight LPC
Download [Hampshire and Isle of Wight LPC]
Cold chain audit
It is important that medicines are stored correctly. Temperature sensitive medicines such as vaccines, insulins and selected eye drops must be stored at a temperature between 2˚C-8˚C. This audit evaluates pharmacy compliance with cold chain guidelines.
Download audit data and collection tools [NHS]
Prescription intervention audit
Interventions are a key part of the role of community pharmacists as it improves patient outcome, improves safety by preventing harm and also ensure value for money for the NHS.
This audit measures the type and number of prescription interventions made by community pharmacists, the audit involves data from 30 interventions being recorded and analysed.
Download audit specification and data collection tools [Essex LPC]
Clinical Audit: Anticoagulant Safety
Anticoagulants are classed as high risk medicines and can cause significant harm when misused or used in error.
This audit aims to:
- Determine patient awareness of key information about their anticoagulant medicine
- Audit current use of anticoagulant alert cards
- Audit compliance with national monitoring requirements for vitamin K antagonists
- Inform a national update of patient held oral anticoagulant information and alert cards
The target population for this audit is all patients’ prescribed anticoagulant medication, for example warfarin, acenocoumarol, phenindione, dabigatran, apixaban, rivaroxaban, edoxaban.
Data can be collated using paper forms or entered directly onto PharmOutcomes. It is recommended that data is collected for approximately 2 weeks and includes a minimum of 15 patients.
Download audit and data collection tools [NHS]
Audit on valproate safety for community pharmacies
Research has shown there is a significant risk of birth defects and development disorders in all children exposed to valproate-containing medicines in utero.
In April 2018, the Medicines and Healthcare products Regulatory Agency (MHRA) changed the licence for valproate containing medicines contra-indicating their use in women of childbearing potential unless they are on a Pregnancy Prevention Programme.
Further information on the Valproate Pregnancy Prevention programme
This audit assesses the role of community pharmacy in supporting women of childbearing potential in taking valproate containing medicines.
The audit is designed to be completed in four sections:
- Section 1 is a pre-audit survey collating information relating to the understanding and awareness of the risks associated with valproate and pregnancy of the pharmacy professional undertaking the audit
- Section 2 involves pro-actively using the pharmacy PMR to identify patients who may be at risk
- Section 3 involves gathering information on the patients encountered within the pharmacy who may be at risk and the actions taken within the pharmacy to support them
- Section 4 records the learning points and reflections from undertaking the audit along with details of the additional actions that will be taken within the pharmacy
The audit should be completed in two separate stages, once in July 2018 and again in November 2018. The data collated should then be submitted to inform the national analysis.