Compliance with documentation of NB-UVB phototherapy protocols in Aziz Fatima Hospital, Faisalabad. A closed-loop audit
DOI:
https://doi.org/10.66344/jpad.v36i3.3469Keywords:
Clinical audit, Narrowband ultraviolet B phototherapy, Documentation, Quality improvementAbstract
Background Narrowband ultraviolet B (NB-UVB) phototherapy is an established treatment modality for several dermatological conditions, including psoriasis, vitiligo, atopic dermatitis and other inflammatory dermatoses. Safe and effective delivery requires appropriate patient selection, dose determination, monitoring of adverse effects, and adequate documentation throughout the treatment course. Inadequate adherence to phototherapy protocols and incomplete documentation may compromise the quality and traceability of phototherapy services. Clinical audits can identify deficiencies in practice and documentation and provide an opportunity for targeted quality improvement. Therefore, a closed-loop audit was conducted in the Dermatology Department of Aziz Fatima Hospital, Faisalabad.
Objective To assess and improve compliance with documentation and protocols of phototherapy in dermatology unit of Aziz Fatima Hospital, Faisalabad.
Methods Thirty patients were selected who were receiving narrowband UVB phototherapy in dermatology unit of Aziz Fatima Hospital, Faisalabad on the basis of established guidelines. A structured audit checklist was used for this closed-loop audit. A standardized phototherapy proformas and consent forms were introduced after identification of deficiencies in initial audit. In addition, logbook was revised and staff was educated regarding phototherapy protocols. After eight weeks, a re-audit was performed using same standards and same number of patients.
Results In the first audit cycle, major deficiencies were found in informed consent, protective measures, record of cumulative dose, documentation of dose increments, and assessment of patients after completing treatment. Following implementation of standardized documentation tools and staff education, documented compliance increased to 100 percent in all parameters.
Conclusion Introduction of standardized documentation tools and staff education improved compliance with NB-UVB phototherapy standards from deficient baseline levels to 100% in all audit parameters.
References
1. Goulden V, Ling TC, Babakinejad P, Dawe R, Eadie E, Fassihi H, et al. British Association of Dermatologists and British Photodermatology Group guidelines for narrowband ultraviolet B phototherapy 2022. Br J Dermatol. 2022;187(3):295-308. doi:10.1111/bjd.21669.
2. Kalia S, Toosi B, Bansback N, et al. Assessing adherence with phototherapy protocols. J Am Acad Dermatol. 2014;71(6):1259-61. doi:10.1016/j.jaad.2014.07.046
3. Moseley H, Allan D, Amatiello H, et al. Guidelines on the measurement of ultraviolet radiation levels in ultraviolet phototherapy. Br J Dermatol. 2015;173(2):333-50. doi:10.1111/bjd.13937.
4. Elmets CA, Lim HW, Stoff B, Connor C, Cordoro KM, Lebwohl M, et al. Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy. J Am Acad Dermatol. 2019;81(3):775-804. doi:10.1016/j.jaad.2019.04.042.
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