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

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

2. 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.

3. 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)

4.  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

5.  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.

6. Basically, there are two types of audit and they
are:
 Internal audit
 External audit

7. 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.

8. 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.

9. 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.

10. 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

11.  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

12.  Nursing Care Plan
 Nurses Note
 Vital signs charts
 Drug charts
 Patient’s Condition
 etc

13. 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.

14. 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.

15.  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)

16. 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:

17.  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.

18.  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)

19. 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

20.  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?

21.  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?

22. 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

23.  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.

24. 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.

25. THANK YOU
FOR
LISTENING

26.  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.

27.  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)