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Nursing audit may be defined as a detailed review and evaluation of selected clinical records in order to evaluate the quality of nursing care and performance by comparing it with accepted standards.

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Quality assurance system motivates nurses to strive for excellence in delivering quality care and to be more open and flexible in experimenting with innovative ways to change outmoded systems.

Nursing Management & Quality Assurance

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The Quality Assurance assignment is designed for you to look at the Medicare website to get a feel for the 5 Star Quality rating of LTC facilities. This is a very interesting time for LTC communities as this system has been overhauled and for the first time these ratings are tied to reimbursement.
The Star rating of a particular care center is composed of three different pieces, health inspection survey, staffing and quality measures. The health inspection survey is weighted more heavily than the others. Surveys occur every 9-15 months and the surveyors look for deficiencies in the care center. The score from the survey is based on the number and severity of the deficiencies found in the last 3 years on the inspections. A poor health inspection score can be detrimental to a facility, preventing the overall rating from reaching any higher than one star above the health inspection score. Other parts of the calculation are staffing and quality measures. Staffing scores are primarily based on the hours of care each resident receives from nursing staff daily. The quality scores are based on 11 different physical and clinical measures, including the percentage of resident reporting severe pain, and those experiencing falls that result in major injury. Each of these components contributes to the overall Star Rating. Unfortunately, the system is set up so that a limited number of centers can be 5 star, only 10% while 20% will be 1 star centers.