Nolan M, Scott G
Research Division, Faculty of Health Studies, University of Wales, Bangor.
J Adv Nurs. 1993 May;18(5):759-66. doi: 10.1046/j.1365-2648.1993.18050759.x.
There can be very few nurses, at the moment, whose daily activity is not in some way influenced by the notion of audit and related concepts. Yet despite an impressive growth in the literature relating to audit, conceptual clarity on a number of key issues remains elusive. This paper suggests that there are major tensions inherent in much of the current thinking about audit. In outlining the arguments supporting our position, we term these tensions primary and secondary. The potential effects of ignoring such tensions are illustrated by reference to the development of day hospital care for older people in the United Kingdom. This is used to highlight a number of paradoxical expectations and deleterious consequences for day hospital services which have arisen from a failure adequately to address a number of fundamental questions. The lessons to be drawn are then applied to audit in general, with particular reference to services for individuals with on-going health care needs.
目前，很少有护士的日常工作不会在某种程度上受到审计观念及相关概念的影响。然而，尽管与审计相关的文献数量显著增长，但在一些关键问题上，概念的清晰度仍然难以捉摸。本文认为，当前许多关于审计的思考中存在着内在的重大矛盾。在阐述支持我们立场的论据时，我们将这些矛盾称为主要矛盾和次要矛盾。通过参考英国为老年人提供日间医院护理的发展情况，说明了忽视这些矛盾的潜在影响。这被用来突出日间医院服务中一些自相矛盾的期望和有害后果，这些后果是由于未能充分解决一些基本问题而产生的。然后将吸取的教训应用于一般的审计工作，特别是针对有持续医疗保健需求的个人的服务。
