HEALTHCARE QUALITY PAGE

Everyone in health care is familiar with the contribution Florence Nightingale made to improving the quality and safety of healthcare services. Since Nightingale’s work, auditing the quality of nursing care came to prominence in the 1950s, with publications on audit by Sister Blanche and PR Fisher. In the 1960s, Marie Phaneuf strongly promoted nursing care audit and offered practical guidance on how to do the audits. In the 1970s, other nursing audit models were promoted including Qualpacs, the Quality of Patient Care Scale, and the Rush Medicus Nursing Process methodology, and Monitor. During the decade alone, at least 37 articles were published illustrating nursing audit and its importance.

 

In 1985, the Royal College of Nursing (RCN) introduced its Dynamic Standard Setting System (DySSSy), engaging nurses across the UK in nursing audit. In the 1990s, the NHS Management Executive published a framework of audit in nursing services, and the Department of Health funded reviews of nursing and therapy audit and nursing audit tools.

 

Yet in the UK today, there are no national clinical audits devoted specifically to nursing practice. Some national audits include aspects of nursing care, but only as part of overall patient care. A systematic review has examined the impact of audit and feedback on nurses’ roles, and another considered nurses’ involvement in audit. However, of articles published in this decade on nursing audit, none comes from the UK.

 

What happened to nursing audit — particularly given this rich history — remains unclear. Quality improvement and patient safety priorities may have displaced the perceived need for audits of nursing practice. But the decline of clinically relevant and scientifically sound nursing audits represents a serious risk. Without robust audit of nursing practice, nursing’s contribution to patient care may be less visible, less measurable, and less able to drive improvement where it is most needed.