Audit and Feedback: An Evidence‐Based Practice Literature Review of Nursing Report Cards

Abstract

Background: As more hospitals transition to electronic health records (EHR) and rely on technology to inform practice, what is done with that information is increasingly important. Performance report cards for physicians and nurses are not new, yet there is little recent evidence on nurse-specific audit and feedback.Aim: The aim of the project was to conduct an evidence-based practice (EBP) review to answer the question, "Does implementing an individualized audit and feedback report tool for nurses improve compliance, adherence, and/or performance of nursing tasks?".Methods: Evidence was gathered from several databases. Reviewers read and appraised articles that answered the EBP question using the Johns Hopkins Nursing EBP Model. Data were then collated to synthesize and generate recommendations.Results: Of the initial 613 unique articles, eight (two research and six quality improvement) were included. Six articles demonstrated improvements while two did not. Articles analyzed nursing documentation (n = 3), tasks or skills (n = 2), and best practice compliance (n = 3). One manuscript utilized an EHR-generated report; all others were completed by hand. Overall, there was not consistent and compelling evidence to support individualized audit and feedback report tools in nursing. However, several themes emerged related to sustainability, timing of feedback, audit, and feedback in the context of quality improvement, and the methods of acquiring and distributing data.

[Retracted] Individualized Management of Quality of Care in Orthopedic Nurses Based on Sensitive Indicators

“…Thus, the goal of accurate assessment can be achieved by actively seeking clues, inquiring and making judgments, enhancing medical and nursing communication, and familiarizing with the cause of injury, surgery, and condition by responsible nurses [ 25 ]. The results show that continuous quality monitoring based on individual nurses can standardize nursing behavior and improve nurse compliance, thereby improving efficiency and quality [ 26 ]. To sum up, the value of sensitive indicators of orthopaedic nursing quality has gradually increased from primary and senior supervisor nurses to nursing team leaders and specialist nurses, and the level of qualifications, experience, knowledge, and skills has been continuously improved.…”

‘It's all about ticks’: A secondary qualitative analysis of nurse perspectives about documentation audit

“…This aspect is compounded by the ‘duplication’ required for nurses to complete documentation, in this case in the ‘green progress notes’ which were more complete, but not audited. To be effective quality improvement tools, audit and feedback cycles must consider clinical priorities, workflows and patient care (Christina et al, 2016; Sinuff et al, 2015; Smyth et al, 2021; Tuti et al, 2017; Vabo et al, 2017). Redley and Raggatt (2017) expose the large volume of risk‐screening and care‐planning documentation expected of nurses, which Allen (2017) dubs ‘formacology’.…”

“…The secondary analysis approach is justified to mitigate research barriers of participation about sensitive content and wasted resources such as participant time (Long‐Sutehall et al, 2011; Ruggiano & Perry, 2019). As a legal document, discussion about nursing documentation completeness and accuracy can be a sensitive topic, and nurses may be reticent in sharing their perceptions due to their perceived or actual vulnerability as an individual or for their organization (Long‐Sutehall et al, 2011; Sinuff et al, 2015; Smyth et al, 2021).…”

Research Types and New Trends on the Omaha System Published From 2012 to 2019

“…“Clinical information systems” in nursing practice requires the quality and design of clinical information systems, such as ease of use and learning, flexibility, and software speed 46 . Further, the efficacy of providing automated audits and feedback reports from electronic health records is unknown in nursing 47 . There is still room for more research on developing clinical information systems using the OS in the future.…”