A COMPARATIVE-ANALYSIS OF 6 AUDIT SYSTEMS FOR MENTAL-HEALTH NURSING

Purpose. To devise an analytical framework to help identify strengths and weaknesses in the audit process as specified by existing psychiatr ic nursing audit systems, in order to analyse current audit practice a nd identify improvements for incorporation in the Newcastle Clinical A udit Toolkit for Mental Health [1]. Data sources. Published material r elating to the following six systems: the Central Nottinghamshire Psyc hiatric Nursing Audit; Psychiatric Nursing Monitor; Standards of Care and Practice; Achievable Standards of Care; Quartz; and Quest. Data ex traction. Comparison of the six systems according to an analytical fra mework derived from detailed empirical study (structures, processes an d outcomes) of one of them in use and the educational evaluation liter ature. Examination of the extent to which guidance is provided for ope rating the systems and for wider process-related aspects of audit. Res ults of data synthesis. Five of the systems failed to specify some imp ortant elements of the audit process. Conceptually, the six systems ca n be divided into two main types: 'instrument-like' systems designed a long psychometric lines and which emphasize the distance between the s ubjects of audit and the operators of the systems, and 'tool-like' sys tems which exploit opportunities for care setting staff to engage in t he audit process. A third type of system is the locally-developed syst em which is offered to a wider audience but which does not make the sa me level of claim to universal applicability Conclusion. The analytica l framework allows different approaches to audit to be compared and co ntrasted not only according to the techniques used, but also according to process issues. The analysis of six systems revealed a variety of different techniques and procedures which can facilitate, in a methodo logically rigorous manner, practitioner and other stakeholder involvem ent in audit processes.