Audit and nursing audit

14 de Sep de 2017

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Audit and nursing audit

  1. AUDIT Presented By, Ms. Ekta. S. Patel, 1st Year M.Sc
  2. *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.
  3. *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.
  4. *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.
  5. •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.”
  6. *Audit is defined as, “it is a process to analyze and evaluate something.”
  7. *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.”
  8. 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.
  9. 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.
  10. 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.
  11. 1. External audit:
  12. • 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.
  13. • 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.
  14. • 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.
  15. Types of external audits: • Financial audit • Operations audit • Compliance audit
  16. 2. Internal Audit:
  17. • 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.
  18. • 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.
  19. • 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.
  20. • 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.
  21. 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.
  22. 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.
  23. • Internal Audit primarily focuses on operational audits but can extend the scope to include accounting procedures that can impact financial reporting.
  24. 3. Compliance audit: • Compliance audits review the level of compliance with internal policies or external regulatory requirements.
  25. 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.
  26. 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.
  27. 6. Administrative audits: • Assess issues related to the efficiency of operational productivity within an organization.
  28. 7. Specialized audit: • There are number of specialized reviews that examine areas such as services performed by third parties and forensic auditing.
  29. 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.
  30. 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
  31. 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.
  32. 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.
  33. 3. Detection risk: • Detection risk is the risk that an audit might not be capable of detecting a material misstatement.
  35. * 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
  36. • 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.
  37. • It includes follow- up or repeating an audit sometimes later to find out if the practice is fulfilling the agreed standards.
  38. • 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.
  39. Retrospective view Concurrent view
  40. 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.
  41. 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.
  42. • It can be also done to identify the job satisfaction of staff nurses in accordance with their work performance.
  43. • 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
  44. THE BASIC AUDIT CYCLE CAN BE DEPICTED AS; 1. Set standards 2. Observe practice changes 3. Compare with standards 4. Implement change
  45. 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.
  46. 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.