AUDIT
Presented By,
Ms. Ekta. S.
Patel,
1st Year M.Sc

*Audit is Latin word.
*Meaning of audit is official examination
of the accounts.
* In today’s global health industry
organizations or service providers are
required to demonstrate that they have
adequate financial controls and
safeguard when they host or process
data of their customers.

*Auditing is originated from accounting
practices and the development of
accounting audit was motivated by the
capitalist production concept, which
used it as tool for financial control.

*In health field, auditing was
introduced in the early 20th century,
as a tool to verify the quality of care,
by analyzing the registers on
medical record.

•Audit is defined as “it is the
process of evaluation or analysis
of something to determine its
accuracy or safety, or is the
document that declares the result
of such an analysis or
evaluation.”

*Audit is defined as, “it is a process to
analyze and evaluate something.”

*Audit is defined as, “it is an
independent review and examination of
records and activities to assess the
adequacy of system controls, to ensure
compliance with established policies
and operational procedures, and to
recommend necessary changes in
controls, policies, or procedures.”

Audit is a vital part of accounting.
Audits were mainly associated with
gaining information about financial
system and financial records of
company or business.
Recent audit includes non financial
subject areas such as, safety, security,
information system performance.

It is process of verifying cost of
manufacturing or producing of any
articles.
A systemic and accurate verification
of cost accounts and records.
An audit must adhere to generally
accepted standards established by
governing bodies.

Identify
government
or other
relevant
external
requirements
.
Documen
t pertinent
laws and
regulation
.
Assess whether
management of
organization and
information system
function have considered
relevant external
requirements in making
plans and setting
policies, standards and
procedures.
Review internal information
system department/
function/activity documents
that address adherence to laws
applicable to industry.
Determine adherence
to established
procedures that
address these
requirements.

1. External audit:

• An external audit is review of financial
statement or report of an entity,
usually a government or business, by
someone not affiliated with
organization or agency.
• It is independent review of financial
documents provided to auditor.

• The audit is conducted by regulatory
agency hired by the entity and the
auditors are generally the public
account.
• For government or public sector, an
external audit will include review of
budget, the allocation of funds and the
actual expenses to ensure the
budgeted revenues and expenses
were correctly complied and used and
in a private sector.

• It includes a review of organization’s
quarterly or monthly financial reports
as well as statements on revenues and
expenditures to ensure they are
correctly tabulated and reported.
• These are usually conducted once a
year at the end of fiscal year.
• A year end financial report is prepared
by entity, which is one of the
documents verified in external audit.

Types of external audits:
• Financial audit
• Operations audit
• Compliance audit

2. Internal Audit:

• Internal audit has been recognizing
as an aid to management for
monitoring the financial performance
and effectiveness of various
departments/ units in the execution of
various program, schemes and
activity.

• Internal audit is an independent
management function, which involves
a continues and critical appraisal of
the functioning of an organization
with a view to suggest improvements
and add value to and strengthen the
overall governance mechanism of
organization or entity, including the
entity’s risk management and internal
control system.

• According to IIA, internal audit is an
independent, objective assurance and
consulting activity designed to add
value and improve organization’s
operations. It helps an organization
accomplish its objectives by bringing a
systematic, discipline approach to
evaluate and improve effectiveness of
risk management, control and
governance process.

• The internal audit activity evaluates
risk exposure relating to
organization’s governance, operation
and information system in relation to
effectiveness and efficiency of
operation, reliability and integrity of
financial and operational information,
safeguarding of assets, and
compliance with laws, regulation and
contract.

1. Financial audit:
• Financial audits typically involve a focus
on financial controls as they relate to
reporting. These audits focus on
accounting controls present in the
general ledger or sub-ledger systems.
Financial statement auditing is the focus
of our external auditors. Internal Audit
will complement the work they perform
based on an agreed plan.

2. Operational audit:
• Operational audits focus on the review
and assessment of a business
process.
• The activities of the business process
may result in a direct or indirect
financial impact to the organization
such as the collection of student
tuitions or patient account balances.

• Internal Audit primarily focuses on
operational audits but can extend the
scope to include accounting
procedures that can impact financial
reporting.

3. Compliance audit:
• Compliance audits review the level of
compliance with internal policies or
external regulatory requirements.

4. Information Systems:
• Audits of Information Systems look at
the overall infrastructure and network
of the University and the controls that
relate to the security of the network
and the systems that are maintained
in support of the goals of the
University. They also include technical
operations, data centre operations,
project management procedures, and
application controls.

5. Integrated Audits:
• Integrated audits look at controls that
address financial, operational,
compliance and information systems
risks. These audits are typically
centred on a business cycle or a
specific part of a cycle or process.

6. Administrative audits:
• Assess issues related to the
efficiency of operational productivity
within an organization.

7. Specialized audit:
• There are number of specialized
reviews that examine areas such as
services performed by third parties
and forensic auditing.

8. Forensic audit:
• Traditionally forensic audit has been
defined as an audit specialized in
discovering, disclosing and follow up
on frauds and crimes. In recent years
the forensic profession has been
called upon to participate in
investigations related to corporate
fraud and cybercrime.

Understanding of audit area
Risk assessment and general audit plan
Detailed audit planning
Preliminary review of audit area/ subject
Evaluating audit area
Compliance testing
Substantive testing
Reporting(communicating results)
Follow up

1. Inherent risk:
• Inherent risk is the risk that a financial
statement is susceptible to a material
misstatement. This statement could
be related to a class of transactions,
account balances or disclosures
about important company dealings.

2. Control risk:
• Control risk is the risk that one or
more material misstatements might
not be detected or prevented on a
timely basis by the internal control
systems of the company.

3. Detection risk:
• Detection risk is the risk that an audit
might not be capable of detecting a
material misstatement.

NURSING AUDIT

* Nursing audit refers to the assessment of
the quality of clinical nursing.
- Elison
* Nursing audit is the means by which
nurses themselves can define standards
from their point of view and describe the
actual practice of nursing.
-Goster Walfer

• It improves the quality of nursing care.
• It compares actual practice with agreed
standards of practice.
• It is formal and systemic.
• It involves peer review.
• It requires the identification of variations
between practice and standards followed
by the analysis of causes of such
variations.

• It includes follow- up or repeating an
audit sometimes later to find out if the
practice is fulfilling the agreed
standards.

• To evaluate the quality of nursing care given.
• To achieve the desired and feasible quality
of care.
• To provide a way for better records.
• To focus on care provided and care provider.
• To provide rationalized care thereby
maintaining uniform standards worldwide.
• To contribute to research.

Retrospective
view
Concurrent view

1. RETROSPECTIVE
VIEW:
• It refers to the detail quality care
assessment after the patient has been
discharged. The records can be reviewed
for completeness of records, diagnosis,
treatment, lab investigations,
consultations, nursing care plan,
complications, and end results.

2. CONCURRENT VIEW:
• It is achieved by reviewing patient care during
the time of hospital stay by the patient. It
includes assessing the patient at the bed- side
in relation to predetermined criteria like errors,
omissions, deficiencies, as well as efficiencies
and also excess in the care of patients under
them. It involves direct and indirect
observation, interviewing the staff responsible
for care, and reviewing the patients' records
and care plan.

• It can be also done to identify the job
satisfaction of staff nurses in
accordance with their work
performance.

• According to Payne, the steps in audit
include;
1. Criteria development
2. Selection of cases
3. Work sheet preparation
4. Case evaluation
5. Tabulation of evaluation
6. Presentation of reports

THE BASIC AUDIT CYCLE CAN BE
DEPICTED AS;
1. Set
standards
2. Observe
practice
changes
3. Compare
with
standards
4.
Implement
change

Patient is assured of good service.
Better planning of quality improvement can
be done.
It develops openness to change.
It provides assurance, by meeting
evidence based practice.
It increases understanding of client‘s
expectations.
It minimizes error or harm to patients.
It reduces complaints or claims.

It may be considered as a punishment to
professional group.
Many components may make analysis
difficult.
It is time consuming
It requires a team of trained auditors.