Nursing audit is defined as the process of collecting information from nursing reports and other documented evidence about patient care and assessing the quality of care using quality assurance programs. The purposes of nursing audit include evaluating nursing care given, achieving desired quality of nursing care, stimulating better record keeping, focusing on care provided rather than the care provider, and contributing to research. Nursing audit uses written standards of care to evaluate nursing practice and identify areas for corrective action and quality improvement. It can be used as a tool for quality control through outcome, process, and structure audits.

1. DEFINITION
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 PROGRAMES.

2. DEFINITION:
I. ACCORDING TO ELISON
"NURSING AUDIT REFERS TO
ASSESSMENT OF THE QUALITY OF
CLINICAL NURSING".
II. ACCORDING TO GOSTER
WALFER
NURSING AUDIT IS AN EXERCISE
TO FIND OUT WHETHER GOOD
NURSING PRACTICES ARE
FOLLOWED.

3. 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 NOT ON
CARE PROVIDER,
•CONTRIBUTES TO RESEARCH.
•EVALUATING NURSING CARE GIVEN.
•ACHIEVE DESERVED QUALITY OF NURSING
CARE.
•STIMULATE TO BETTER HEALTH.
•CONTRIBUTES TO RESEARCH.

4. CONCEPT OF NURSING AUDIT
•THE CONCEPT OF NURSING AUDIT IS BASED
ON DEBIT AND CREDIT SYSTEM.
•DEBIT SYSTEM
•CREDIT SYSTEM

5. 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
PERCENT CONFORMANCE RATE.
•EXAMINATION & ANALYSIS OF FINDINGS.
•EVIDENCE OF CORRECTIVE ACTION BEING TAKEN.
•EVIDENCE OF EFFECTIVENESS OF CORRECTIVE
ACTION.
•APPROPRIATE REPORTING OF THE AUDIT
PROGRAMME.

6. AUDIT RESEARCH
 Is not randomised  May be randomised
 Compares actual performance
against standards
 Identifies the best approach, and thus
the sets the standards
 Conducted by those providing the
service
 Not necessarily provided by those
providing the service
 Usually led by service providers  Usually initiated by researchers
 Does not involve investigation of new
treatments, but evaluates the use of
current treatments
 Involves comparators between new
treatments and placebos
 Involves review of records by those
entitled to access them
 Requires access by those not
normally entitled to access them
 Ethical consent not normally required  Must have ethical consent
 Results usually not transferable  Results may be general sable
 Hypothesis used to generate the
standard
 Testable hypothesis generated
 Compares performance against the
standard
 Presents clear conclusions
DIFFERENCE BETWEEN AUDIT AND RESEARCH

7. TYPES OF AUDIT: THERE ARE TWO
TYPES-
•INTERNALAUDIT: IT IS CARRIED OUT
CONTINUOUSLY BY HOSPITAL STAFF
AND WHICH CONSIST OF PROCESS OF
SEPARATING AND CLASSIFYING
CLINICAL RECORDS AND EVALUATING
THE CLINICAL CARE GIVEN.
•EXTERNALAUDIT: AN OUTSIDE
AGENCY PERIODICALLY TESTS THE
COMPLETENESS AND ACCURACY OF
INTERNAL AUDIT.

8. METHODS OF NURSING AUDIT
There are two methods:
•Retrospective view
•Concurrent review

9. METHOD TO DEVELOP CRITERIA:
1. DEFINE PATIENT POPULATION.
2. IDENTIFYA 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

10. POINTS TO BE REMEMBERED:
A. QUALITYASSURANCE MUST BE A
PRIORITY,
B. THOSE RESPONSIBLE MUST IMPLEMENT A
PROGRAMME NOT ONLY A TOOL,
C. A CO-ORDINATOR SHOULD DEVELOPAND
EVALUATE QUALITYASSURANCE 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,

11. AUDIT
CYCLE
SET
STANDARDS
OBSERVES
PRACTICE
COMPARE
THE
STANDARDS
IMPLEMENT
CHANGES
AUDIT CYCLE

12. STEPS TO PROBLEM SOLVING PROCESS IN PLANNING
CARE:
A. COLLECTS PATIENT DATA IN A SYSTEMATIC
MANNER,
1. INCLUDES DESCRIPTION OF PATIENT’S 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.
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,

13. PROCESS OF NURSING AUDIT
METHODS TO DEVELOP CRITERIAARE:
•DEFINE PATIENT POPULATION.
•IDENTIFY A TIME FRAMEWORK 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.

14. AUDIT AS A TOOL FOR QUALITY
CONTROL
THE AUDITS MOST FREQUENTLY USED
IN QUALITY CONTROL INCLUDE
OUTCOME, PROCESS AND STRUCTURE
AUDITS.
•OUTCOME AUDIT
•PROCESS AUDIT
•STRUCTURE AUDIT

15. ADVANTAGES OF NURSING AUDIT:
•CAN BE USED AS METHODS OF
MEASUREMENT IN ALL AREAS OF NURSING.
•SEVEN FUNCTIONS ARE EASILY
UNDERSTOOD,
•SCORING SYSTEM IS FAIRLY SIMPLE,
•RESULTS EASILY UNDERSTOOD,
•ASSESSES THE WORK OF ALL THOSE
INVOLVED IN RECORDING CARE,
•MAY BE A USEFUL TOOL AS PART OF A
QUALITYASSURANCE PROGRAMME IN AREAS
WHERE ACCURATE RECORDS OF CARE ARE
KEPT.

16. DISADVANTAGES OF THE 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 CARE

17. •BIBLIOGRAPHY
•http://currentnursing.com/nursing_management/
nursing_audit.html
•Kamal S Jogelkar. Hospital word management;
professional adjustments and trends in nursing.
Mumbai; Vora medical- publications : 1990.
•BT Basavanthappa. Nursing Administration.
New Delhi; Jaypee Brothers 2002.
•A Comprehensive textbook of Community
Health Nursing, Bijayalaxami DASH first
edition(2017) , Page no 772-774

18. Made By:
Akansha John
M.Sc Nursing