This document provides an overview of nursing audits, including definitions, types, purposes, processes, and the audit cycle. Some key points:
- A nursing audit is defined as the evaluation of nursing care through retrospective analysis of nursing records to assess quality.
- The main types of audits discussed are internal/external audits, financial/operational audits, department reviews, and integrated/investigative/follow-up audits.
- Purposes include evaluating nursing care quality, verifying records, focusing on care provided and providers, and contributing to research.
- The nursing audit process involves setting criteria, designing audit tools, planning and implementing the tool, recording/analyzing results,
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.
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
Nursing Audit is a method of quality assurance that involves a detailed review and evaluation of clinical records by qualified professional personnel to evaluate the quality of nursing care.
It is defined as the specification of roles and functions of the nature of job of each individual who has to deliver effectively in order to be retained in the institution.
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
Nursing Audit is a method of quality assurance that involves a detailed review and evaluation of clinical records by qualified professional personnel to evaluate the quality of nursing care.
It is defined as the specification of roles and functions of the nature of job of each individual who has to deliver effectively in order to be retained in the institution.
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
ABOUT THE TRAINING PROGRAM :-
Root cause analysis (RCA) is a class of problem solving methods aimed at identifying the root causes of problems or events. The practice of RCA is predicated on the belief that problems are best solved by attempting to address, correct or eliminate root causes, as opposed to merely addressing the immediately obvious symptoms. By directing corrective measures at root causes, it is more probable that problem recurrence will be prevented.
DESIGNED FOR :-
Managers, Engineers, Supervisor and officers engaged in maintenance operation and engineering activities.
OBJECTIVE :-
At the end of the training program, participants will be able
- To gain a basic understanding of the problem solving and decision-making process and the applicable quality tools that support this process.
- To develop specific competencies to use the structured approach to problem solving and decision making and the supporting quality tools.
TRAINING PROGRAM COVERAGE :-
- Basic knowledge about RCA program.
- What are the RCA tools ?
- More about Why- Why analysis ?
- Videos and case studies on RCA
With so many challenges faced by the managers everyday, the best way to handle and excel in one's task is DELEGATION.It not only proves to be one of the best way to manage your work but helps groom your subordinates and polish them to be as do as you.And only when you have sum one to take up your task that you can move forth taking up your boss's
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.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
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.
Stay informed, stay safe, and get your flu shot today!
2. MEANING Quality - a judgment of what constitutes good or bad. Audit - a systematic and critical examination to examine or verify.
3. CONT……… Medical audit - the systematic, critical analysis of the quality of medical care, including the procedures for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patient.
4. DEFINITION Nursing audit - (a) It is the assessment of the quality of nursing care (b) Uses a record as an aid in evaluating the quality of patient care. Nursing audit is defined as the evaluation of nursing care in retrospect through analysis of nursing records. It is a systematic format and written appraisal by nurses of the quality of content and the process of nursing service from the nursing records of the discharged patient.
5. CONT……. According to Elison "Nursing audit refers to assessment of the quality of clinical nursing". According to GosterWalfer 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.
6. TYPES OF AUDIT 1. INTERNAL AUDITING: Internal auditing is a control technique performed by an external auditor who is an employee of the organization. Manager makes an independent appraisal 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.
7. CONT……… 3. Financial audit: It is a historically oriented, independent evaluation performed for the purpose of attesting to the fairness, accuracy, and reliability of financial data. 4. Operational Audit: It is a future-oriented, systematic, and independent evaluation of organizational activities. Financial data may be used, but the primary sources of evidence are the operational policies and achievements related to organizational objectives.
8. CONT….. 5. Department Review: It is a current period analysis of administrative functions, to evaluate the adequacy of controls, safeguarding of assets, efficient use of resources, compliance with related laws, regulations and University policy and integrity of financial information. 6. Integrated Audit: It is a combination of an operational audit, department review, and audit application controls review. This type of review allows for a very comprehensive examination of a functional operation within the University.
9. CONT……… 7. Investigative Audit: It is an audit that takes place as a result of a report of unusual or suspicious activity on the part of an individual or a department. It is usually focused on specific aspects of the work of a department or individual. 8. Follow-up Audit: These are audits conducted approximately six months after an internal or external audit report has been issued. They are designed to evaluate corrective action that has been taken on the audit issues reported in the original report. When these follow-up audits are done on external auditors' reports, the results of the follow-up may be reported to those external auditors.
10. BRIEF HISTORY OF NURSING AUDIT * Before 1915- very little was known about the concept. * 1918- industrial concern introduced for the beginning of medical audit. * George Groword- introduced the term physician for the first time medical audit. *Ten years later Thomas R Pondon MD established a method of medical audit based on procedures used by financial account. * He evaluated the medical care by reviewing the medical records.
11. PURPOSES OF NURSING AUDIT * Evaluating nursing care given * Achieves deserved and feasible quality of nursing care * Verification: stimulant to better records * Focuses on care provided and on care provider * Contributes to research * Review of professional work or in other words the quality of nursing care ie, we try to see how far the nurses have confirmed to the norms and standards of nursing practice while taking care of patients.
12. CONT……… * 1955- First report of nursing audit of the hospital published * Next 15 years, nursing audit is reported from study or record. * The program is reviewed for record nursing plan, nurses’ notes, patient condition, nursing care.
13. CONT……… * It encourages followers to be actively involved in the quality control process and better records. * It clearly communicates standards of care to subordinates. * Facilitates more efficient use of health resources. * Helps in designing response orientation and in-service education programme.
14. Methods of Nursing Audit There are three methods: a. Retrospective review b. The concurrent review c. Peer review
15. CONT……… 1. Retrospective review - this refers to an in-depth assessment of the quality after the patient has been discharged, have the patients chart to the source of data.
16. CONT……… 2. The concurrent review - this refers to 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 and reviewing the patients record and care plan.
17. CONT……… 3. 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.
18. ESSENTIAL CHARACTERISTICS OF NURSING AUDIT There should be: * Written standards of care against which to evaluate nursing care. * Evidence that actual practice was measured against such standards, sharing a a percent conformance rate. * Examination and analysis of findings. * Evidence of corrective action being taken. * Evidence of effectiveness of corrective action. * Appropriate reporting of the audit programme.
19. TRAINING FOR AUDITORS SHOULD EVALUATE THE FOLLOWING a) A group discussion to see how the group rates the care received using the notes of a patient who has been discharge these should be anonymous and should reflect a total period of care not exceeding two weeks in length b) Each individual auditor should then under take same exercise as followed by a meeting of the whole committee who compare and discuss its finding and finally reach a components
20. PROCESS OF NURSING AUDIT A) Set the key criteria (item): It should be measurable against identifiable values, set standard and in terms of desired patient outcome. Methods to develop criteria are: # Define patient population # Identify a time frame work for measuring outcomes of care. # Identify commonly recurring problems presented by the defined patient population. # State patient outcome criteria. # State acceptable degree of goal achievement. # Specify the source of information.
21. CONT………… B) Prepare Audit Protocol: keeping in mind audit objectives, target groups, methods of information gathering (by asking, observing, checking records), criterion are measuring, identifying the time framework for measuring outcome of care, identify commonly recurring nursing problems, state acceptable of goal achievement.
22. CONT……… C) Design The Type Of Tool: # Quality assurance must be a priority. # Those responsible must implement a program not only a tool not only a tool. # Roles and responsibilities must be delivered. # Nurses must be informed about the process and the results of the program.
23. CONT……… # Data must be reliable. # Adequate orientation of data collection is essential. # Quality data should be analyzed and used by nursing personnel at all levels.
24. CONT………… D) Plan and implement the tool: What is to be evaluated? Who is going to collect the information? How many sample in the target group? Time period? E) Recording/ Analysis, concluding: Record the information, analyze the information, make a summary, and compare with set standard, conclusion.
25. CONT……… F) Using Results: The result aid to modify nursing care plan and nursing care process, including * discharge planning, * for selected patient outcome * implementing a program for improving documentation of nursing care through improved charity policies, methodologies and forms, * focusing of nursing rounds * team conferences.
26. CONT……… # Focusing supervisory attention upon areas of weakness identified such as one particular nursing unit or specific employees. # Designing responsive orientation and in-service education programs. # Gaining administrative support for making changes in resources, including personnel.
27. The Audit Cycle 1. DEFINE THE STANDARDS THE AUDIT CYCLE 5. REVIEW STANDARDS 2. MEASURE CURRENT PRACTICE 4. DECIDE AND IMPLEMENT ACTION 3. IDENTIFY GAPS
28. AUDIT CYCLE Step 1: Define the Standard Standards comprise two elements that define the context for care and a third which shows how care is delivered. 1. Structure– environmental elements required to deliver care. E.g. policy, procedures, clinic setting, equipment, record keeping system etc. 2. Process– professional elements required to deliver care. E.g. KSF, SIGN guidance,
29. CONT………… 3.Outcome– measurable elements demonstrating results of care. E.g. Leg ulcer healing time, breast feeding duration, immunization levels, smoking cessation, dying at home, asthma/diabetic stability, pressure ulcer prevalence etc. The elements contain criteria, which should be Reliable, Understandable, Measurable, Behaviourable and Acceptable
30. CONT………… Step 2: Measure current practice within the selected topic A baseline enquiry is carried out to identify problems requiring a solution to improve the quality of patient care. Step 3: Identify gaps in service provision
31. CONT………… Step 4: Decide and Implement action * This is the hardest area to address and involves the input from the whole team. * An action plan needs to be developed.
32. CONT………… Step 5: Review standards # If the standard is easily met, does it need to be raised? # Is the standard too high? # What are the future needs?
33. Steps to problem Solving Process in Planning Care : a) Collects patient data in a systematic manner 1. includes description of patients pre-hospital routines, 2. has information about the severity of illness, 3. has information regarding lab tests, 4. has information regarding vital signs, 5. Has information from physical assessment etc.
34. CONT………… b. States nurses diagnosis, c. Writes nursing orders, d. Suggests immediate and long term goals, e. Implements the nursing care plan, f. Plans health teaching for patients, g. Evaluates the plan of care,
35. PREREQUISITES OF NURSING AUDIT: Audit Committee * Audit committee consist of members including senior nurses as members to do nursing audit. * This committee should comprising of a minimum of five member who are interested in quality assurance are clinically competent and able to work together in a group.
36. CONT……… * 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 50 discharge per month, all the records may be audited. If there are a large number of records to be audited, an auditor may select 10% of discharge. * The impetus must come from the nursing staff themselves, realizing the benefits to the patients and themselves.
37. Audit as a Tool for Quality Control 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. Example of outcomes traditionally used to measure quality of hospital care include mortality, its morbidity, and length of hospital stay.
38. CONT……… 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.
39. CONT……… 3. Structure audit Structure audit monitors 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.
40. ADVANTAGE OF NURSING AUDIT 1. Can be used as a method of measured in all areas of nursing 2. Scoring system is fairly simple 3. Results easily understood 4. Assess the work of all those involved in recording care 5. May be useful tool as part of a quality assurance programme in areas where accurate records of care are kept
41. CONT……… 6) Enables the professional group to highlight the deficiencies and how good they are in giving care. 7) Better planning can be done. 8) Helps in reallocation of resources. 9) Administrators are also sure that patients are getting quality care.
42. 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
43. CONT……… 5) Deals with a large amount of information. 6) Only evaluates record keeping. It only serves to improve documentation not nursing care. 7) Medical legal importance. 8) The professionals feel that they will be used in court of law as any document can be called for in court of law.
44. ROLE AND FUNCTIONS OF NURSE MANAGER FOR EFFECTIVEQUALITY CARE: Roles: # Encourages followers to be actively involved in the quality control process. # Clearly communicates standards of care to subordinates. # Encourages the setting of high standards to maximize quality instead of setting minimum safety standards. # Implement quality control proactively instead reactively.
45. CONT……… # Uses control as a method of detraining why goals were not met. # Is positively active in communicating quality control finding. # Acts as a role model for followers in accepting responsibility and accountability for nursing action.
46. CONT…… Functions: # In conjunctions with other personnel in the organization establishes clear cut, measurable standards of care and determines the most appropriate methods for measuring if those standards have been met. # Selects and uses process, outcome and structure audits appropriately as quality control tools.
47. CONT…… # Assesses appropriate sources of information in data gathering for quality control tools. # Determines discrepancies between care provided and unit standards and seeks further information regarding why standards were not met. # Uses quality control findings as a measure of employee performance and rewards, coaches, counsels or disciplines employees accordingly. # Keeps abreast of current government and licensing regulations that affect quality control.
48. RESEARCH STUDY: A study was conducted to analyze current audit practice and identify improvements for incorporation in the Newcasde Clinical Audit Toolkit for Mental Health. Published material relating to the Central Nottinghamshire Psychiatric Nursing Audit like Psychiatric Nursing Monitor; Standards of Care and Practice; Achievable Standards of Care; Quartz; and Quest are used. The result shows that Five of the systems failed to specify some important elements of the audit process.
49. CONT………… Conceptually, the six systems can be divided into two main types: 'instrument-like' systems designed along psychometric lines and which emphasize the distance between the subjects of audit and the operators of the systems, and 'tool-like' systems which exploit opportunities for care setting staff to engage in the audit process. A third type of system is the locally-developed system which is offered to a wider audience but which does not make the same level of claim to universal applicability.