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NURSING
 AUDIT jayadeepa
   J
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.
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.
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
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
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
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
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
Evaluation of nursing audit

• There are 3 types of evaluation of nursing
  audit:


  1) Retrospective evaluation
  2) Concurrent evaluation
  3)Peer review
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.
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.
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
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
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
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
Audit cycle

Set standards

Implementation change observe

practice

Compare with standard
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
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
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
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.
Thank you

   By ,
          Jayadeepa J

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Nursing audit

  • 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
  • 16. Audit cycle Set standards Implementation change observe practice Compare with standard
  • 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.
  • 21. Thank you By , Jayadeepa J