الفهرس 
Introduction
Clinical AuditOnly 14 pages are availabe for public view
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Abstract
• Clinical audit: A quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the review of change.
• We conducted our audit aiming to audit surgical performance for laparoscopic ovarian drilling done for PCOS at Women’s Health Hospital including patient selection for LOD, evaluation (clinical and laboratory, sonographic), standard laparoscopic procedure and postoperative follow compared to the standard audit criteria using the audit research tool.
• This thesis was prospective observational study to all cases undergoing laparoscopic ovarian drilling at WHH in the period between 1/5/2014 to 30/4/2015.100 cases were included in both phases (50 cases for each phase and orientation session was concluded between them).
• For patient selection for LOD: significant improvement in the 2nd phase of audit as regard the clear indication for PCOS drilling. Assessment of all favourable factors for PCOS drilling does not show any significant difference between the two phases of audit except for assessment of BMI which should be less than 30 kg/m2.
• Ovarian drilling was done as a part of diagnostic laparoscopy without a preoperative plan for drilling and without a preoperative diagnosis for these cases as PCOS in 18% vs.10% for 1st vs. 2nd phase.
• For clinical evaluation:Significant improvement as regard evaluation of acne and BMI.evaluation of hirsutism by Modified Ferriman-Gallwey Score were not done absolutely at both phases.
• For laboratory evaluation,Significant improvement in the 2nd phase as regard prolactin.no significant difference in laboratory evaluation of other hormones.laboratory evaluation for TSH and testosterone shows substandard evaluation.
• The ultrasonographic evaluation of PCOS show substandard reports as regard detection of number of antral follicles and measurement of the ovarian volume in both phases of audit.
• As regard the ovarian drilling procedure, significant improvement for standard timing, non-significant difference for the other items (site of punctures, number, power, bilaterality and type of energy).
• Postoperative care: The immediate follow up of vital signs and checking the patients before discharge show significant improvement but still unsatisfactory for the medical service applied at WHH. Instructions about importance of ovulation monitoring and keeping a record menstrual cycle have significant rise in the 2nd phase, but stills need more orientation for our residents. No significant difference for the other items of postoperative care and discharge instructions.