nursing audit

nursing audit

1. NURSING AUDIT

2. HISTORY OF NURSING AUDIT Before 1955 very little was known about the concept of “Nursing Audit”. George Groward a physician was the first one to pronounce the term medical audit in 1918. Ten years later Thomas. R. Pondon HD established a method of Medical Audit based on procedures used by financial account. The 18 th report of Nursing Audit of the hospital published in 1995.

3. MEANING The word “audit” comes from the Latin word “ Auditus ” means a “hearing ”. It originally meant hearing of facts and argument about a situation to determine truth . Nursing audit is a useful tool for measuring the quality of nursing received by patients.

4. Like financial audit nursing audit also have debit and credit concept . The debit in terms are --- death of patients (gross or net), complications, infection, error in procedures, absconded patients and patients left against medical advice etc . The credit in terms are---- recovered patients, cured patients, health educational activities, preventive services performed etc.

5. DEFINITIONS Nursing audit is an objective technique by which the level of nursing care and services delivered to patients by nursing personnel is determined by systematic critical analysis of nursing records. According to Elison “Nursing Audit refers to a assessment of the quality of clinical nursing”.  

6. According to Goster Walfer Nursing Audit is an exercise to find out whether good nursing practices are followed. The audit is a means by which nurses themselves can define standards from their point of view and describe the actual practice of nursing.

7. PURPOSES OF NURSING AUDIT To orient nurses with the quality control programme for nursing. To evaluate the degree of quality patient care against defined criteria. To justify cost-incurred on human and material resources. To take remedial action towards cost effectiveness. To justify the proposal for additional staffing or resources to the management. To stimulate better records.

8. To facilitate research activities. To facilitate the co-operative planning and delivery of client care by physicians and nursing employees. To Enrich and provide direction to in service education effects. To provide a specific management technique in carrying out evaluation and control function. To identify ways to improve patient care.

9. CHARACTERISTICS It improve the quality of nursing care It compares actual practice with agreed standards of practice. It is formal and systemic. It involves peer review. It requires the identification of variations between practice and standards of followed by the analysis of causes of such variations. It provides feedback for those whose records are audited. It includes follow up or repeating an audit sometimes later to find out if the practice is fulfilling the agreed standards.

10. METHODS OF NURSING AUDIT There are two methods : Retrospective view – The concurrent review—

11. OTHER TYPES OF NURSING AUDITS   Structure Audit:   Structure audit monitor the structure or setting in which patient care occurs such as the finances, nursing service, medical records and environment. This audit assumes that a relationship exists between quality care and appropriate structure these above audits can occur retrospectively, concurrently and prospectively.  

12. Process audit: Process audits are used to measure the process of care or how the care was carried out. Process audit is task oriented and focuses on whether or not practice standards are being fulfilled. These audits assume that a relationship exist between the quality of the nurse and quality of care provided.

13. Outcome Audit: Outcomes are the end result of care: the changes in the patient’s health status and can be attributed to the delivery of health care services. Outcome audits determine what results if any occurred as result of specific nursing intervention for clients. These audits assume the outcome accurately and demonstrate the quality of care that was provided.

14. TYPES OF AUDITORS Internal auditors External auditors

15. PROCEDURE FOR NURSING AUDIT Formulate committee Meeting of committee Assigning format Filling and compiling Submission of report

16. procedure of audit is continuous cyclic process AUDIT CYCLE

17. METHOD TO DEVELOP CRITERIA FOR AUDITING   Define patient population, Identify a time framework for measuring outcomes of care, Identify commonly recurring nursing problems presented by defined patient population. State patient outcome criteria. State acceptable degree of goal achievement Specify the source of information.

18. 7.Design and type of tool. Quality assurance must be a priority. Those responsible must implement a programme not only a tool. A coordinator should develop and evaluate quality assurance activities. Roles and responsibilities must be delivered. Nurses must be informed about the process and the result of the programme . Data must be reliable. Adequate orientation of data collection is essential. Quality data should be analyzed and used by nursing personnel at all levels.

19. ADVANTAGES OF NURSING AUDIT Can be used as a method of measurement in all areas of nursing. Scoring system is fairly simple. Result easily understood. Assesses the work of all those involved in recording care, May be a useful tool as part of a quality assurance programme in areas where accurate records of care are kept. Patient is assured of good service .

20. Cont……………. It develops openness to change It provide assurance, by meeting evidence based practice. It increases understanding of client’s expectations. It minimizes error or harm to patients. It reduce complain or claim.

21. DISADVANTAGES OF THE NURSING AUDIT Appraises the outcomes of the nursing process, so it is not so useful in areas where the nursing process has not been implemented. Many of the components overlap making analysis difficult. It is time consuming.

22. Cont…………. Requires a team of trained auditors. Deals with large amount of information. Only evaluates record keeping. It only serves to improve documentation, not nursing care. It may be considered as a punishment to professional group.

23. CONCLUSION Nursing audit programme is useful to evaluate the nursing care rendered. It enables the nursed administrator to uncover inefficient care and save the nursing staff from the problem of medico-legal implication due to incomplete records. The programme audit acts as a control device to improve standard of performance by nursing personnel.

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