Evidence Based Practice (EBP), Quality Improvement (QI) and Research are tools for problem solving and inform each other. [1]
- QI analyses existing data to improve systems related to business processes and outcomes (ie, cost, productivity, quality). Audit is a QI activity.
- EBP analyses existing data for purposes of ranking evidence that will be used to answer questions that guide practice.
- Research validates and refines existing data or generates new knowledge to influence nursing practice, systems and policies. [2]
Clinical audit has been defined as a quality improvement strategy that intends to measure and improve the care and outcomes patients experience. [3] It is a proven and effective process for measuring quality and driving improvement. [4] An audit is a snapshot of current practice against best practice, target performance. This is done by the selection of aspects of patient care and the evaluation of the performance of a service against an agreed set of criteria or standards to answer the following questions:
• What is happening now? (baseline)
• What should be happening? (according to evidence, best practice, other agreed standards, which provide the criteria for the audit)
• How can we improve? (changes and interventions required)
• Have our improvements resulted in a change? (repeated audits as part of the cycle to close the gap).
For audit and feedback the choice of comparator impacts on quality improvement outcomes, with no single comparator suited to all recipients and contexts. [5] As a result of these activities a change in practice is often indicated, with appropriate change management strategies required for effective implementation.