Nursing management audit: the reaction of users

This paper describes the results of an evaluation research project into the Doncaster Nursing Management Audit scheme. The scheme, in line with similar ‘nursing audits’ in Europe and North America, has the objective of improving the quality of nursing care. This quality is dependent on both clinical and administrative procedures working correctly. At Doncaster there exists the nursing care audit (for nursing staff below the supervisory grade) and the nursing management audit (for staff at and above the supervisory grade). The Doncaster Nursing Management Audit distinguishes itself from other types of nursing audit in two main ways. Firstly, it focuses on the management aspects of a nurse's responsibilities and secondly, the scheme allows the nurse to self‐assess her own performance. The findings of the evaluation suggest that nurses see the audit as particularly valuable in developing them as managers and making them aware of their own potential. The single most unfavourable outcome of using audit was found to be the frustration created amongst nursing staff by their inability to change some nursing practices. The study showed that nursing staff who were occupationally mobile, whose supervisors had a strong interest in the use of audit and who were receiving a large amount of feedback on their performance were benefiting more from audit than their colleagues. Certain factors connected with the introduction and conduct of audit were found to have an important effect on its success. These included the manner in which audit was introduced into the organization, the way it was linked up with staff appraisal and the frequency with which it was conducted. The results indicate that audit has a great potential contribution to make to the improvement of the quality of nursing management provided it is used flexibly and adapted to the needs of the organization to which it is applied.