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We nurses easily use the word “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: 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 beginning 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 reviewing 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 records of nursing plan and nursing care.Meaning of terms: 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 carePowerPoint Presentation: 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 patientDefinition:: Definition: 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.PowerPoint Presentation: 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 resulting outcome and quality of life for the patientTypes of audit: Types of audit 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 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 sheet after careful examination of the relevant books of accounts and documentsEvaluation of nursing audit: Evaluation of nursing audit There are 3 types of evaluation of nursing audit: 1) Retrospective evaluation 2) Concurrent evaluation 3) Peer reviewPowerPoint Presentation: 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.PowerPoint Presentation: 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.PowerPoint Presentation: 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 recordsPurposes of nursing audit: Purposes of nursing audit Evaluating nursing care given Achieves deserved and feasible quality of nursing care Stimulant to better records Focuses on care provided and on care provider Contributes to researchMethods of nursing audit: 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 informationPowerPoint Presentation: 7) design and type of tool a) quality assurance must be priority b) those responsible must implement a program 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 program 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 levelsAudit cycle: Audit cycle Set standards Implementation change and observe practice Compare with standardAdvantage of nursing audit: Advantage of nursing audit Can be used as a method of measured in all areas of nursing Seven functions are easily understood Scoring system is fairly simple Results easily understood Assess the work of all those involved in recording care May be useful tool as part of a quality assurance program in areas where accurate records of care are keptDisadvantage of nursing audit: Disadvantage of 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 Is time consuming Requires a team of trained auditors Deals with a large amount of information Only evaluates record keeping. It only serves to improve documentation not nursing carePowerPoint Presentation: 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 dischargeConclusion: 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.PowerPoint Presentation: Thank you By , Jayadeepa J You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.