Nursing audit is a systematic evaluation of nursing care quality and outcomes. It involves comparing nursing services to established standards through record review. Nursing audit aims to ensure quality nursing care, stimulate better record-keeping, and contribute to research. It can evaluate care in all nursing areas. The audit process involves setting standards, implementing changes, observing practice, and comparing to standards in a continuous cycle. While time-consuming, nursing audit is a tool for quality assurance and improvement.
2. NURSING AUDIT
The world trend of professional
accountability to an enlightened public can
no longer be ignored by nursing. We nurses
easily use the worlds “quality nursing” but
have we defined what we mean by quality?
Do you know our deficiencies? Are we ready
to admit our deficiency to our peers? Are we
taking steps to remedy them? Only by such
self regulation we can relate our identity with
the health professional as nature partners.
3. Brief history of nursing audit
• Nursing is an evaluation of nursing service. Before 1955
very little was known about the concept. It was
introduced by the industrial concern and the year 1918
was the being of medical audit.
• George Groword pronounced the term physician for the
first time medical audit ten years later Thomus R Pandon
MD established a method of medical audit based on
procedures used by financial account. He evaluated the
medical care by reviewed the medical records.
• First report of nursing audit of the hospital published in
1955. For the next 25 years nursing audit is reported
from study or records on the last decade. The
programmer is reviewed from record nursing plan,
nursing care.
4. Meaning of terms
Quality
A judgment of what constitute good or bad
Audit
A systematic and critical examination to examine
or verify
Nursing audit
1) It is the assessment of the quality of nursing
care
2) Uses a record as an aid in evaluating the
quality of patient care
5. Nursing standards
Defines a standard as the desirable and
achievable level of performance against which
actual practice is compared. The standards
must meet the needs of the patient
6. Definition:
1) According to elision ‘nursing audit refers to assessment of the
quality of clinical nursing’
2) According to Goster welfare
a) Nursing audit is an exercise to find out whether good nursing
practices are followed
b) The audit is a means by which nurses themselves can define
standards from their point of view and describe the actual
practice of nursing
3) A nursing audit is a method of evaluating care that evolve
reviewing patient records to assess the outcomes were
achieved
7. Nursing care audit
Audit related to the planning, delivery and
evolution of care. It is an important
component of nursing care
Medical audit; the systematic critical analysis of
the quality of medical care including the
procedures for diagnosis and treatment the
use of resource and the result sing outcome
and quality of life for the patient
8. Types of audit
1) Internal auditing
Internal auditing is a control technique performed by
an external auditor who is an employee of the
organization. Makes an independent appraisal the
policies, plans and points the deficits in the policies or
plans and give suggestion for eliminating deficits
2) External auditing
It is an independent appraisal of the organizations
financial account and statements. The external auditor
is a qualified person who has to certify the annual
profit and loss account and prepare a balance street
after careful examination of the relevant books of
accounts and documents
9. Evaluation of nursing audit
• There are 3 types of evaluation of nursing
audit:
1) Retrospective evaluation
2) Concurrent evaluation
3)Peer review
10. Retrospective evaluation :
• It means relating to past events. It is the
evaluation of a clients record after discharge
from agency.
• It may use post discharge questionnaires
patient interview( by telephone , face to face )
or chart review, Nursing audit to collect data.
• The type of retrospective audit most familiar to
nurses working in hospitals is the retrospective
chart review. This activities body initially
required hospitals to conduct certain number
of per year.
11. Concurrent audit :
• It is the evaluation of a client’s health care
while the client is still receiving care from the
agency.
• These evaluation use interviewing direct
observation of nursing care and review of
clinical records to determine whether the
specific evaluative criteria have been met.
12. Peer review :
• In nurse peer review nurses functioning in the same
capacity that is peer’s appraise the quality of care or
practice performed by others equally qualified nurses.
The peer review is based on pre-established standards or
criteria.
There are two types of peer reviews. Individual and nursing
audit
• a) Individual peer review; focuses on the performance of
an individual nurse
• b) Nursing audit; focuses on evaluating nursing care
through the review of records
13. Purposes of nursing audit
1) Evaluating nursing care given
2) Achieves deserved and feasible quality of
nursing care
3) Stimulant to better records
4) Focuses on care provided and on care
provider
5) Contributes to research
14. Methods of nursing audit
1) define patient population
2) identify a time framework for measuring
outcomes of care
3) identify commonly recurring nursing
problems presented by the defined patient
population
4) state patient outcome criteria
5) state acceptable degree of goal achievement
6) specify the source of information
15. 7) design and type of tool
a) quality assurance must be priority
b) those responsible must implement a
programmer not only a tool
c) a coordinator should develop and evaluate
quality assurance activity
d) roles and responsibilities must be delivered
e) nurses must be informed about the process
and the result of the programmed
f) data must be reliable
g) adequate orientation of a data collection is
essential
h) quality data should be analyzed and used by
nursing personnel at all levels
17. Advantage of nursing audit
1) Can be used as a method of measured in all
areas of nursing
2) Seven function are easily understood
3) Scoring system is fairly simple
4) Results easily understood
5) Assess the work of all those involved in
recording care
6) May be useful tool as part of a quality assurance
program in areas where accurate records of
care are kept
18. Disadvantage of nursing audit
1) Appraises the outcomes of the nursing
process , so it is not so useful in areas where
the nursing process has not been
implemented
2) Many of the components overlap making
analysis difficult
3) Is time consuming
4) Requires a team of trained auditors
5) Deals with a large amount of information
6) Only evaluates record keeping. It only serves
to improve documentation not nursing care
19. Audit committee
Before carrying out an audit committee should be
informed comprising of a minimum of five member
who are interested in quality assurance are clinically
competent and able to work together in a group. It is
recommended that each member should review not
more than 10 patients each month and that the auditor
should have the ability to carry out an audit in about
15 minute. If there are less than 150 discharge per
month. Then all the records may be audited if they all
the records to be audited then an auditor may select
10% of discharge
20. Conclusion
A professional concerns for the quality of its
service constitute the heart of its
responsibility to the public. An audit helps to
ensure that quality of nursing care desired and
feasible is achieved. This concept is often
referred to as quality assurance.