A Quality Audit Project on Compliance with Thermal Safety Documentation in Physiotherapy

Abstract

Background and Objectives: Thermal modalities are widely used in physiotherapy but carry risks of preventable burn injuries if not applied and documented safely. A verification study at Hospital Sri Aman revealed 0% compliance with Model of Good Care (MOGC) standards, highlighting critical gaps in thermal safety practice. This study aimed to identify contributing factors and implement targeted interventions to improve documentation compliance and patient safety. Methods: A retrospective quality assurance study was conducted using convenience sampling. Baseline compliance was assessed in 20 physiotherapy records using a standardised MOGC-based audit checklist. A Knowledge, Attitude and Practice (KAP) questionnaire was administered to seven physiotherapists to identify barriers to compliance. Based on the findings, a standardised thermal safety checklist and staff training programme were implemented, followed by a post-intervention audit. Results: Baseline case-based compliance was 0% and item-based compliance was 54.3%, with major gaps in temperature verification and skin assessments. Following the intervention, case-based compliance improved to 90% (18/20) and item-based compliance to 98.6%, exceeding the ≥90% target. Compliance for pre- and post-treatment skin assessments reached 100%, while temperature verification improved from 0% to 90%. Conclusion: Identifying system-related barriers through KAP assessment enabled targeted interventions. A standardised thermal safety checklist combined with staff training significantly improved compliance with MOGC documentation standards, enhancing patient safety and clinical consistency.