EBP / QI / Research / Audit

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.

  1. Cepero J. Differences among quality improvement, evidence-based practice, and research. J Neurosci Nurs. 2011 Aug;43(4):230-2.
  2. Shirey MR, Hauck SL, Embree JL, Kinner TJ, Schaar GL, Phillips LA, et al. Showcasing differences between quality improvement, evidence-based practice, and research. J Contin Educ Nurs. 2011 Feb;42(2):57-68; quiz 69-70. Epub 2010 Jul 6.
  3. National Institute for Clinical Excellence. Principles for best practice in clinical audit. Abingdon: Radcliffe Medical Press; 2002.
  4. Burgess R, editor. New principles of best practice in clinical audit. 2nd ed. Oxford(GB): Radcliffe publishing; 2011.
  5. Gude WT, Brown B, van der Veer SN, et al. Clinical performance comparators in audit and feedback: a review of theory and evidenceImplement Sci. 2019;14(1):39. Published 2019 Apr 24. doi:10.1186/s13012-019-0887-1

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Guidelines / Documents / Factsheets

These audit toolkits include both instruction and templates that can be used to establish local auditing programs.



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Last updated 25 September 2018