Staff-related Predictors of Knowledge and Practice of Clinical Audit among Doctors in a Tertiary Health Facility in a Developing Country: A Cross-Sectional Study

Background: Clinical auditing lowers mortality and morbidity and enhances the quality of patient care. This study identified staff-related determinants of the knowledge and practice of clinical audit (CA) among physicians in a Nigerian tertiary facility. Method: Convenience sampling of 460 doctors was employed in this descriptive cross-sectional study using pre-tested questionnaires. Frequency distributions, binary and multivariate logistic regression were conducted using SPSS 23.0. A P-value ≤0.05 was considered significant for the inferential statistics. Results: A response rate of 99.3% was obtained from the analysis of 457 questionnaires. Out of these, only 57 (12.5%) clearly understood the CA process. Those who are consultants (AOR 44.2, 95%CI:4.6, 425.5; p = 0.001), senior registrars (AOR 14.8, 95%CI:1.7, 126.0; p = 0.014), and registrars (AOR 10.2, 95%CI:1.3, 79.0; p = 0.027) were significantly more knowledgeable in CA compared to Interns. Mortality reviews were commoner in Surgery (p=0.021), Obstetrics/gynaecology (p=0.027) and Paediatrics (p<0.001) than in other specialties. Consultants were more involved in mortality audits (p=0.05) compared to other cadres. Survey of patient experiences, process audits and cost of care analyses were more common among physicians with 10-19 years in practice. Conclusion: Significant gaps exist the knowledge and practice of CA among doctors in this tertiary hospital. Addressing these deficiencies requires targeted efforts in education, policy interventions, and institutional reforms to strengthen clinical governance and improve quality of care.