Nursing audit assists in:
1. Evaluating Nursing care given,
2. Achieving deserved and feasible quality of nursing care,
3. Stimulating better nursing records maintenance,
4. Focuses on patient care provided and not on care provider,
5. Contributes to research in nursing.
THE EXPENSE OF QUALITY IS AN INTERACTIVE PROCESS BETWEEN CUSTOMER & PROVIDER. QUALITY ASSURANCE USUALLY FOCUSES ON MATERIAL, GOOD WORK & SERVICE PROVIDED EFFECTIVELY. ANY LACK IN SERVICE PROVIDED CAUSES DECREASE IN QUALITY
THE EXPENSE OF QUALITY IS AN INTERACTIVE PROCESS BETWEEN CUSTOMER & PROVIDER. QUALITY ASSURANCE USUALLY FOCUSES ON MATERIAL, GOOD WORK & SERVICE PROVIDED EFFECTIVELY. ANY LACK IN SERVICE PROVIDED CAUSES DECREASE IN QUALITY
The health care system and the nursing profession is expanding globally , there fore it is important for nurses to know the trends, issues and challenges in new millennium.
The health care system and the nursing profession is expanding globally , there fore it is important for nurses to know the trends, issues and challenges in new millennium.
Nursing audit, a tool for providing quality care to patientsGure2
it is a presentation that highlights what makes nursing audit a tool for quality care to patients. it further highlight the challenges and its prospects
nursing records and reports, definition, purposes, principles, values and uses, types, records in hospital, types of reports, how to write better report, nursing responsibilities
UNIT-IV M.sc I year NURSING AUDIT CHN.pptxanjalatchi
Nursing audit is the process of collecting information from nursing reports and other documented evidence about patient care and assessing the quality of care by the use of quality assurance programmes.
Nursing Audit Dr. Rangappa. S .Ashi SDM Institute of Nursing sciences Shri D...rangappa
Nursing audit one of the control tools, responsible for controlling the activities of the nurses that focuses on providing the best possible nursing care. The actual nursing rendered is compared with the standards. This is mainly refers to clinical nursing audit. The nursing management audit is an evaluation of nursing management as a whole. It is critically examination of the entire nursing management process.
All hospitals should be disability friendly, to ensure easy movement of disable patients. The presentation arrives at a solution to the all above disability issues to serve as a guide line.
In the presentation, a summary of initiatives to be taken by hospitals in different areas for patient safety have been described for the knowledge, practices and implementation of patient safety initiative by hospital managers/Administrators.
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
The presentation describes in brief the patients need, expectations and how to develop the patient care and feedback system to obtain maximum patient satisfaction.
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
Emergency is the gateway to the hospital, patients with pain and agony, relative emotionally charged enter the emergency department at any hour of the day or night, expecting immediate treatment and solace.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. NURSING AUDIT
With the implementation of CPA professional
accountability to an enlightened public can no
longer be ignored by nursing staff.
“Quality nursing care” has become essential on
day to day functioning.
Nursing audit is a way of ensuring quality nursing
care.
Nursing audit is a detailed review and evaluation
of selected clinical records by qualified
professional personnel to identify, examine, or
verify the performance of certain specified aspects
of nursing care by using established criteria.
3. HISTORY OF NURSING AUDIT
One of first ever clinical audits was undertaken by Florence
Nightingale during the Crimean war of 1853-1855.
On arrival at the medical barracks hospital in Scutari in
1854, Florence was pained by the unsanitary conditions and
high mortality rates among injured or ill soldiers.
She and her team of 38 nurses applied strict sanitary
routines and standards of hygiene to the hospital and
equipment,
Florence's gift of statistic kept meticulous records of the
mortality rates among the hospital patients.
Another famous figure who advocated clinical audit
was Ernest Codman (1869–1940) by monitoring surgical
outcomes .
Whilst Codman's 'clinical' approach is in contrast with
Nightingale's ‘epidemiological' audits, both methods serve to
highlight the different methodologies that can be used in the
process of providing quality patient care.
4. Before 1955 very little was known about the concept
of nursing audit.
First report of Nursing audit of the hospital
published in 1955.
For the next 15 years, nursing audit is reported from
study or record on the last decade.
The program is reviewed from record nursing plan,
nurses notes, patient condition, nursing care.
5. 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
not on care provider,
5. Contributes to research.
7. TYPES OF NURSING AUDIT
1) Internal auditing:
Internal auditing is a control technique performed
by an external auditor who is an employee of the
organization. He 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 qualifed person who has to certify the
annual pprofit and loss account and prepare a
balance street after carefull examination of the
relevant books of accounts and documents
8. INTERNAL AUDIT
• RETROSPECTIVE EVALUATION : Retrospective audit is a
method for evaluating the quality of nursing care by examining
the nursing care as it is reflected in the patient care records for
discharged patients.
• In this type of audit specific behaviors are described then they
are converted into questions and the examiner looks for answers
in the record.
For example the examiner looks through the patient's records
and asks :
a. Was the problem solving process used in planning nursing care?
b. Whether patient data collected in a systematic manner?
c. Was a description of patient's pre-hospital routines included?
d. Laboratory test results used in planning care?
e. Did the nurse perform physical assessment?
f. How was information used?
g. Were nursing diagnosis stated?
h. Did nurse write nursing orders? And so on.
9. II. CONCURRENT AUDIT : It is performed during ongoing
nursing care.
The evaluations conducted on behalf of patients who are still
undergoing care.
It includes assessing the patient at the bedside in relation to
pre-determined criteria,
Interviewing the staff responsible for this care .
Reviewing the patients record and care plan.
III. 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:
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.
10. QUALITY AUDIT
1. OUTCOME AUDIT:
Outcomes are the end results of care;
The changes in the patients health status and can be
attributed to 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.
Outcomes traditionally used to measure quality of hospital
care include mortality, its morbidity, and length of hospital stay.
11. 2. 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 focus on whether or not
practice standards are being fulfilled.
These audits assumed that a relationship exists between the
quality of the nurse and quality of care provided.
3. STRUCTURE AUDIT:
Structure audit monitors the structure or setting in which patient
care is provided.
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.
13. PRE-REQUISITE FOR NURSING
AUDIT
CLINICAL
AUDIT
CLINICAL AUDIT PLANNING
COMMITTEE MEDICAL CARE
RE
ORIENTATION
OF AUDITORS
14. AUDIT COMITTEE
Before carrying out an audit, an audit committee
should be formed, comprising of a minimum of five
members
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.
That the auditor should have the ability to carry out
an audit in about 15 minutes.
If there are less than 50 discharges per month, then
all the records may be audited,
If there are large number of records to be audited,
then an auditor may select 10 per cent of discharges.
15. RE ORIENTATION OF AUDITORS
a. A detailed discussion of the seven components of
criteria.
b. A group discussion to see how the group rates the
care received using the notes of a patient who has
been discharged,
c. These should be anonymous and should reflect a
total period of care not exceeding two weeks in
length
d. Each individual auditor should then undertake the
same exercise as above.
e. This is followed by a meeting of the whole
committee who compare and discuss its findings, and
finally reach a consensus of opinion on each of the
components.
16. PLANNING MEDICAL CARE
a. Collects patient data in a systematic manner,
. includes description of patients pre-hospital
routines,
has information about the severity of illness,
has information regarding lab tests,
has information regarding vital signs,
Has information from physical assessment etc.
b. State nurses diagnosis,
c. Writes nursing orders,
d. Suggests immediate and long term care,
e. Implements the nursing care plan,
f. Plans health teaching for patients and students,
g. Evaluates the plan of care at own level,
17. SIX STAGES OF NURSING AUDIT
STAGE –I
PREPARING FOR AUDIT
STAGE –II
SELECTING CRITERIA
USING METHODS STAGE –III CREATING
MEASURING PERFORMANCE ENVIRONMENT
STAGE –IV
MAKING IMPROVEMENT
STAGE –V
SUSTAINING IMPROVEMENT
STAGE-VI
RE AUDIT
18. SELECTING A TOPIC
-starting point
-careful thought and planning
- There seems little point in trying to audit
a rare condition, with an insignificant
outcome
19. PLANNING AUDIT
Involve ALL the people concern.
Fix time and Plan resources
Access the evidence/data
Methodology to be followed
Pilot study
Report for Action
Re-audit
All activities should be documented.
20. DEVELOPING CRITERIA
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
Points to be remembered:
a. Quality assurance must be a priority,
b. Those responsible must implement a programme not only a tool,
c. A coordinator should develop and evaluate quality assurance
activities,
d. Roles and responsibilities must be delivered,
e. Nurses must be informed about the process and the results of the
programme,
f. Data must be reliable,
g. Adequate orientation of data collection is essential,
h. Quality data should be annualized and used by nursing
21. MEASURING LEVEL OF PERFORMANCE
•The data collected are to be precise
•Essential data
•Completed data
•Adequate data
•User group to be included
Example:
Immunisation status of pregnant women
•Do not try and collect too many items, keep it simple and
short.
•Computer stored data, Case notes/Medical Records,
Surveys , Questionnaires, Interviews Focus Groups,
•Prospective recording of specific data
- How will this be done to get required information
-Compare performance against the criteria
-Keep focused on the objective of the audit
22. MAKING IMPROVEMENTS
IDENTIFYING BARRIERS TO CHANGE:
- Fear
- Lack of understanding
- Low morale
- Poor communication
- Individual Culture
- Doubt of outcome
-Consensus not gained
SYSTEMATIC APPROACH:
•identification of local barriers to change
•change culture
•support of teamwork
•use of a variety of specific methods like delegation and
accountability
23. SUSTAINING IMPROVEMENT
MONITORING AND EVALUATION:
systematic approach to changing professional practice
should include plans to:
•monitor and evaluate the change
•maintain and reinforce the change
REINFORCING IMPROVEMENT:
•reinforcing or motivating factors by the management .
•integration of audit
•strong leadership
6. RE-AUDIT:
-Review evidence
-Measure effectiveness
-Decide how often to re-audit
- Ongoing process monitoring
-Adverse incidents
-Significant events audit
24. ADVANTAGE Vs DISADVANTAGE
ADVANTAGE DISADVANTAGE
• Can be used as a method of • appraises the outcomes of the
measurement in all areas of nursing process, so it is not so
nursing. useful in areas where the
• Seven functions are easily nursing process has not been
understood, implemented,
• Scoring system is fairly simple, • many of the components
• Results easily understood, overlap making analysis
difficult, is time consuming,
• Assesses the work of all those
• requires a team of trained
involved in recording care,
auditors,
• May be a useful tool as part of a
• deals with a large amount of
quality assurance programme
information,
in areas where accurate records
of care are kept. • only evaluates record keeping.
It leading to improve
documentation, not nursing
care
25. CONCLUSION
A profession dedicated for the
quality of its service to patients
constitutes the heart of its
responsibility to the public.
An audit helps to ensure that the
quality of nursing care desired and
feasible is achieved.
This concept is often referred to as
quality assurance.
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DR. N. C. DAS