Implementation of Concurrent Nursing Audit: An Experience Report

Abstract

Nursing audit is a management tool capable of assisting in the improvement of care quality and efficiency of hospital charges and may be performed concurrently, in other words, while the patient receives care. This study aims to describe nurses' experience about the implementation of concurrent nursing audit in a hospital environment. This is a report on an experience in the period from 2009 to 2014 at a hospital in the state of Rio Grande do Sul, Brazil. The following steps of this process are discussed: Instrument elaboration, Sensitization of the nursing team and Operation of concurrent audit. The results show the feasibility and benefits of adopting this model, especially regarding the reduction of time to send the bill to the health insurances, greater interaction between auditors and care teams, creation of indicators, and contributions to the improvement of healthcare quality and nursing records.

A importância dos registros de enfermagem no faturamento hospitalar

“…31 From the thematic analysis of the studies that composed this integrative review, three thematic categories emerged to investigate the relation between Nursing records and hospital billing: Hospital Environment and Nursing Registries; 11,13,18,[29][30] Nursing Audit and Hospital Billing 12,19,22,27 and The nurse professional in front of the audit sector. 14,17,26,28…”

“…times, it is necessary for the auditor to assume the role of educator, enabling the professionals to perform the improvements resulting from situations identified from the documentary analysis. 14,17,26,28 When care is performed with quality, it reduces the time spent in the institution and brings satisfaction to the patient. In this sense, the on-site audit narrows relations with other professionals facilitating the insertion of educational actions based on the good practices of Nursing.…”

“…In this sense, the on-site audit narrows relations with other professionals facilitating the insertion of educational actions based on the good practices of Nursing. 17 The weaknesses prevalent in the Nursing audit contemplate several inconsistencies, namely: lack of care (42.3%); absence of check (42%); absence of records in Nursing prescriptions (11%); erasures in Nursing prescriptions (4%); incorrect request of materials and medications by Nursing (0.27%) and incomplete header (0.02%). 35 In relation to the absence of verification, it was observed that the least verified items were gases (55%), drugs (36%) and materials (6%) followed by procedures (3%) and monitoring (1% ).…”

Faturamento De Curativos Grau Ii E Registros: Contribuições Da Enfermagem

“…22 In this context, the nurse auditor should not only identify deficiencies in the records, with the main objective being the excellence of nursing care, but should also consider the traditional costs and hospital charges. 23 The importance of nurses knowing the entire process of the procedure billing and costs is mentioned in a study that considers nurses as a management tool, because they play an important role in the control and management of physical, human, material, and financial resources, in addition to their participation in strategic planning. 6 The ignorance with regard to costs can lead to erroneous analyses on the expenses and often, as a consequence, inappropriate decision-making with regard to the current situations.…”

Out-of-pocket payments in hospital bills: a challenge to management

“…These costs can impact not only the patient, but also the professional, the health institution and even the health insurance company. Auditing is a tool of controlling expenses in this scenario (2) .…”