Adaptation of the nursing audit to community health nursing.

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.