Background:

Chronic rhinosinusitis is a common condition in adults worldwide with significant morbidity and impact on quality of life. The appropriate clinical and imaging diagnosis modalities for this condition have been debated and consensus recommendations for practice have been proposed.

Objectives:

The goal of this project was to improve local practice in clinical and imaging diagnosis of Chronic rhinosinusitis in adults in Patan Hospital in Nepal.

Methods:

The project used the Joanna Briggs Institute’s Practical Application of Clinical Evidence System and Getting Research into Practice audit tool in out-patient department of Otolaryngology and Head and Neck Surgery at Patan Hospital in Nepal. The evidence summary was generated based on a structured search of literature. The audit criteria were devised as shown in Table 1. A baseline audit was conducted followed by implementation of change strategies as shown in Table 2 and a follow up audit was conducted.
A sample size of 30 was met for the first two audit criteria in both the baseline and follow-up audits. However, there was zero observation for third criterion in the baseline audit and sample size of only one was possible for the other three audit criteria. Similarly, there were no observations for four criteria in the follow-up audit.

Results:

In the baseline audit, the percentage of compliance was 100% for 1st, 4th, 5th, 6th audit criteria, 53% for 2nd criterion and no observation for 3rd criterion as shown in Figure 1. In the follow up audit, 100% compliance was observed for 1st audit criterion and 97% for the 2nd one (significant improvement in use of nasal endoscopy) and zero observations were available for 3rd to 6th audit criteria as shown in Figure 2.

Conclusions:

This project was successful in attaining a significant improvement in the diagnostic practice for chronic rhinosinusitis in adults, specifically the use of nasal endoscopy. This project not only translated the evidence into practice but was also able to highlight the importance of nasal endoscopy for the correct diagnosis and subsequently improved the standard of the treatment.