Nursing audit--nurses evaluating nursing.
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The quality assurance initiative was taken in 1984 in Papua New Guinea as a result of numerous public criticisms of the services and the care given and/or observed by patients and the community. The approach to quality assurance chosen for this nursing audit is a problem-oriented and patient-focused structure, process and outcome method based on World Health Organization principles and adapted from the Dynamic Standard Setting System.
A selected literature review has revealed some of the ways in which the audit can be adapted to effectively evaluate the quality of care provided by community health professionals. Although a complex issue, the strengths of the audit can outweigh its limitations when a shared philosophy is adhered to and a review of the quality monitoring process occurs on a regular basis. But its success depends both on the approach and on the action taken. One requirement for an effective audit is a strong commitment of staff to reflect accurately nursing practice in nursing documentation. As the audit is neither inclusive nor exclusive, it should be used in conjunction with other quality assurance mechanisms, and in collaboration with other disciplines. Commitment at all levels--consumer, provider, administrator--is essential for success. There is no doubt that the variety of nursing audit instruments and techniques in existence have served to enhance the effectiveness and efficiency of community health nursing audit programs as well as contributing to community health nursing quality assurance. However, the audit clearly remains a challenging issue, requiring further research to establish the reliability and validity of current audit measures and to develop innovative approaches to future community-based audits.
The quality of nursing care delivered to two groups of patients suffering from diabetes mellitus was examined. Using Phaneuf's Nursing Audit, a retrospective audit of the nursing documentation regarding the care of all patients was carried out, and a comparison made of the numeric scores obtained. The nursing care of the group of patients from the Professional Nursing Unit (PNU) obtained mean scores which were 26.4% higher than those obtained by the group from the general hospital wards. There are major variations in scores in specific areas. These give rise to some questions regarding the value to nurses of the caring and nurturing component of nursing work, and how this is affected by differing philosophies and environments.
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