Evaluation
of Clinical Practice Across Settings
M.
Dee Williams, Ph.D, RN
Associate Dean for Clinical Affairs
University of Florida College of Nursing
Problem
Development of a quality
improvement program that includes comprehensive chart audits
of nine nurse practitioner specialty practices was the focus
of this project.
Evidence
Chart audit tools
from five practices were analyzed to determine common elements.
Four included assessment of minimum medical records standards;
three included billing compliance measures; two contained
practice-specific, evidence-based clinical protocols and
patient outcomes.
Strategy
A four- person team, comprised
of a women's health practitioner, an adult health practitioner,
a pediatric clinical specialist, and a practice administrator,
identified medical records and billing compliance items
that could be monitored across practices. Using nationally
recognized standards of care, practice-specific audit items
were developed for seven nursing specialty practices. Chart
reviews will be conducted in May and June 2003; peer review
will follow.
Practice change
The need for
a more uniform method of practice evaluation preceded this
project. Nurse practitioners from a variety of practice
settings agreed to participate in the quality improvement
program.
Evaluation
Practitioner feedback
will be used to refine the quality improvement program,
including audit criteria.
Recommendations
Nurse practitioners
from each of the practices participating in the quality
improvement program must participate in development of
meaningful evaluation criteria and in peer review.
Reference
Stevens, K.R. (2002). ACE Star Model of EBP: The Cycle
of Knowledge Transformation. Academic Center for Evidence-based
Nursing. www.acestar.uthscsa.edu.
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