This document discusses nursing audit, including definitions, types, purposes, process, and roles of nursing audit. It defines nursing audit as the evaluation of nursing care through retrospective analysis of nursing records to assess quality. The main types discussed are internal/external auditing and financial/operational/departmental auditing. Purposes include evaluating care quality and stimulating better record-keeping. The nursing audit process involves setting standards, measuring current practice, identifying gaps, implementing actions, and reviewing standards. The nurse manager's role is to effectively implement quality control through nursing audit.
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.
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 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 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.
quality assurance slides include components, models, approaches, cycle of quality assurance is included in the slides.
the slide gives a brief ides regarding all the points and gives a comprehensive picture of the topic.
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 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.
quality assurance slides include components, models, approaches, cycle of quality assurance is included in the slides.
the slide gives a brief ides regarding all the points and gives a comprehensive picture of the topic.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
How many patients does case series should have In comparison to case reports.pdfpubrica101
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https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
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The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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nursingaudit.pdf
1.
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 Goster Walfer
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) DesignTheType OfTool:
# 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
THE AUDIT
CYCLE
1. DEFINE THE STANDARDS
5. REVIEW
STANDARDS
2. MEASURE CURRENT
PRACTICE
3. IDENTIFY GAPS
4. DECIDE AND
IMPLEMENT ACTION
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 EFFECTIVE QUALITY 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.