nursing audit, a tool for providing quality care to patients

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BY: ALHAMDU SHADARI (RN, RORLNP, PGDE) 31 ST JULY, 2013

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Page 1: Nursing audit, a tool for providing quality care to patients

BY:

ALHAMDU SHADARI

(RN, RORLNP, PGDE)

31ST

JULY, 2013

Page 2: Nursing audit, a tool for providing quality care to patients

Nursing audit is generally seen as a new area in nursing care, especially in Nigerian context of health delivery process.

Its main focus is evaluation of nursing duties that have been rendered to patients while on admission and or after they are discharge home.

Increase in the public awareness of their right of safety have necessitate nurses to be more accountable for the care they deliver, hence quality nursing has become very essential on day to day functioning, and nursing audit is a tool for ensuring quality care.

Page 3: Nursing audit, a tool for providing quality care to patients

Since the time of Florence Nightingale, who wrote in 1858 that the goal of nursing was "to put the patient in the best condition for nature to act open him," nursing leaders have described nursing as both an art and a science.

The American Nurses Association in its social policy statement (2003) defined nursing as the diagnosis and treatment of human responses to health and illness. (Suzanne 2010)

Page 4: Nursing audit, a tool for providing quality care to patients

Virginia Henderson was one of the first modern nurses to define nursing. She wrote, "The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary

Page 5: Nursing audit, a tool for providing quality care to patients

Barbara(2011) viewed Audit as a systematic review and evaluation of records and other data to determine the quality of the services or products provided in a given situation.

A.S Hornby(2006) sees audit as an official examination of the quality or standard of something.

Audrey (2012) et al, also see audit as the examination of records.

Page 6: Nursing audit, a tool for providing quality care to patients

Basically, there are two types of audit and they are:

Internal audit

External audit

Page 7: Nursing audit, a tool for providing quality care to patients

www.currentnursing.com view nursing audit as a process of reviewing patients’ record in order to evaluate the quality of nursing care rendered.

Barbara 2011, sees Nursing audit as an evaluation of structure, process and outcome as a measurement of the quality of nursing care.

Page 8: Nursing audit, a tool for providing quality care to patients

1. To evaluate Nursing care given.2. . Provide the evidence of the quality of nursing

services being rendered.3.To achieve deserved and feasible quality of nursing

care.4. To stimulate better records.5. Contributes to research.6. Evaluating Nursing care given.7. Improve nursing care in existing units and plan for

new practices.8. It increases medico-legal protection.9. to measure progress.

Page 9: Nursing audit, a tool for providing quality care to patients

Basically, there are three types:

a. RETROSPECTIVE VIEW .

b. THE CONCURRENT REVIEW.

C. PEER REVIEW: in this method nurses functioning in the same capacity, appraise the quality of care or practice performed by others equally qualified nurses.

Page 10: Nursing audit, a tool for providing quality care to patients

This committee should comprise of twelve to fifteen members but a minimum of five members who are clinically competent and able to work together in a group.

An audit committee should be form comprising the following:

Head of nursing research unit or continuing education unit-chairman

Page 11: Nursing audit, a tool for providing quality care to patients

Representative from the professional nursing association-members

Representatives from all cadre of nurses-members

Representatives of other hospital professionals e.g medical record, librarian-consultants

Director of nursing services-ex-officio member www.currentnursing/nursmag/nursingaudit

Page 12: Nursing audit, a tool for providing quality care to patients

Nursing Care Plan

Nurses Note

Vital signs charts

Drug charts

Patient’s Condition

etc

Page 13: Nursing audit, a tool for providing quality care to patients

according to Udontre (2012)The committee in discharging its obligation will determine the extent of the quality of care and come up with either of the following:

1. Outcome Outcomes are the end results of care; the changes in the patient’s health status and can be attributed to delivery of health care services. Outcome audits determine what results occurred following specific nursing intervention for clients.

Page 14: Nursing audit, a tool for providing quality care to patients

2. Process It deals with the way the care was delivered.

It assumes that there is a relationship between the quality of care given by a nurse and the manner in which the care is given.Process audits are used to measure the process of care or how the care was carried out.

Page 15: Nursing audit, a tool for providing quality care to patients

3. Structure This audit assumes that a relationship exists between quality care and appropriate structure. Structure audit monitors the structure or setting in which patient care occurs, such as how conducive the environment is, are instruments and equipment available? Are the are stationaries always available? (www.slideshare.net/nursingaudit)

Page 16: Nursing audit, a tool for providing quality care to patients

WHAT IS QUALITY?

Is a judgment of what constitutes good or bad.

Quality is doing the right thing right, right away – (Advocates of Total Quality Management, 1990).

Nursing audit plays the following roles as a tool for quality nursing care:

Page 17: Nursing audit, a tool for providing quality care to patients

It help in the assessment of the work of all those involved in the care. As such those involve will always give out their best to the patient so that there will be no lapses on their part

It Provide the evidence of the quality of nursing services being rendered.

It is a useful tool for quality assurance programme in areas where accurate records of care are kept.

Page 18: Nursing audit, a tool for providing quality care to patients

Nursing Audits enable nurse managers, health care administrators and even nurses themselves to evaluate the effectiveness of nursing interventions and the quality of care given to clients.

Promote better record keeping by nurses.

Focuses on care given and not the care providers.

Contributes to Research- the third leg of the tripod of sound professional practice- education, practice and research.(www.authorstream.com/presentation)

Page 19: Nursing audit, a tool for providing quality care to patients

BEFORE WE TALK OF THE CHALLENGES, LET US NOTE THAT:

Nursing Audit cannot be implemented where the Nursing process is not utilized for patient or client care because it appraises the outcome of the nursing process.

Nursing audit cannot be implemented where there are no records of the care given. E.g vital signs charts, nurses notes, drug charts etc

It cannot be implemented where there is no accurate and comprehensive data required for the Audit

Page 20: Nursing audit, a tool for providing quality care to patients

Are nurses implementing the Nursing process in rendering care?

Are nurses’ notes up to date enough to provide comprehensive data required for the Audit?

Nursing audit focuses on the process or the way the care was delivered because the quality of the care given largely depends on the way it was delivered. How do nurses deliver their care to patients. E.g dressing of wound, do nurses maintains aseptic technique in doing it?

Page 21: Nursing audit, a tool for providing quality care to patients

The quality of care nurses render also depends on appropriateness of the setting (the structure, environment) where the care occurs. Are nurses provided with a conducive environment, instruments and equipment to deliver their care?

Page 22: Nursing audit, a tool for providing quality care to patients

Hornby 2006 said that prospect is the possibility that something will happen or the chances of something being successful.

Basically, the prospect of nursing audit depends on the solutions to the enumerated challenges above.

that is :

If nursing process is fully implemented

If nurses’ notes and record of the care delivered is upto date and comprehensive

Page 23: Nursing audit, a tool for providing quality care to patients

If the process of delivering the care is of standard

If nurses are always provided with a conducive atmosphere, equipment, stationaries and instruments needed for nursing care.

Based on that, it seems the future is bright for nursing audit. If only those challenges are overcomed, nursing Audit will be realistic.

Page 24: Nursing audit, a tool for providing quality care to patients

Nursing profession must be concerned about the quality of its service to the public. This in deed is a major responsibility of the profession to the public. An audit helps to ensure that the quality of nursing care desired and feasible is achieved. The Nursing Audit, if instituted, will serve as one of the several tools for evaluating current nursing practice and for identifying means of improving practice.

Page 25: Nursing audit, a tool for providing quality care to patients

THANK YOU FOR

LISTENING

Page 26: Nursing audit, a tool for providing quality care to patients

Audrey Berman & Shirlee Snyder (2010), Kozier & Erb’s Fundamentals of Nursing concepts, process and practice. 9th edition, Pearson Education, inc. New Jersey.

Hornby A.S, (2006), Oxford Advance Learners Dictionary, 7th edition. University press, Longman, London.

Barbara F. Weller, (2011), Bailliere’s Nurses’ Dictionary. 25th edition. Hercourt Brace and Company Limited, Oval Road London.

Page 27: Nursing audit, a tool for providing quality care to patients

Suzanne C. Smeltzer (2010) et al, Brunner& Suddarth’s Textbook of Medical-Surgical Nursing. 12th edition, Wolters Kluwer Pvt. Ltd, New Delhi.

www.currentnursing.com (10th December, 2010) www.slideshare.net/nursingaudit(24th May, 2012) www.currentnursing/nurs.mng/nursingaudit

(24th May, 2012) www.authorstream.com/presentation (24th May,

2012) www.wikipedia.com/clinical audit(24th May,

2012)