1Professor & HOD, Department of Community Health Nursing, Government College of Nursing Mysore Medical College and Research Institute
2Dean (Nursing), AECS Maaruti College of Nursing, Bangalore
Development of nursing (RCH) audit tool to assess the RCH services provided by nursing personnel based on the Records maintain at Urban and Rural Health Centers in Hassan District, Karnataka with following objectives.
To Develop Nursing Audit Tool to Assess RCH services provided by Nursing Personnel based on their expected performance and to Audit the RCH service Records maintained by Nursing Personnel and also to assess the effectiveness of orientation programme on RCH services audit tool for Nursing Personnel at Urban and Rural Health Centers.
A Quantitative Retrospective and Prospective audit design was adopted for the study. The population was the RCH records maintained by FHWs working in PHCs of Hassan district Karnataka. Systematic Random sampling technique was used to audit RCH Records by using the prepared nursing (RCH) audit tool. Tool consists of 14 components with 575 items and 1150 scores.
The content validity of the tool was 0.92 and discriminative index varied from 0.30 and 0.70 and difficulty index ranged from 0.39 and 0.78. The reliability coefficient calculated by using Spearman Correlation Coefficient (test retest) method ‘r’ value was 0.96. Internal consistency was tested by using coefficient alpha the value was 0.93. Inter-rater reliability was found to be 0.93. In retrospective audit 2042 in urban and 1822 records in rural health centers were audited, orientation and guidelines were provided to FHWs and after six months prospective auditing 946 in urban and 816 in rural areas RCH records were undertaken.
The study revealed that in urban health centres overall means score was 52.85% which was higher than the in Rural Health Centres 50.7%. The Wilcoxon Signed Rank Test Z value 3.10 indicated significant difference between Urban and Rural Audit Score at p <= 0.01 level. Whereas, in urban health centres the prospective audit score was 95.50% in which it was higher than the Retrospective Audit Score of 52.85%. The difference between the Retrospective and Prospective audit score was 42.65%, ‘Z’ value 3.30 is significant at p<= 0.01 level. In rural health centre the overall mean percent of retrospective audit score was 50.71% and prospective audit score was 93.78%. The difference between the Retrospective and Prospective audit score was 43.07 percent. A Wilcoxon Signed Rank test Z value 3.31 in at p<= 0.01 level indicated statistical significance. Further, the Prospective Audit Score of RCH Services in urban Health Centers was 95.50% which was higher than the Prospective Audit score of Rural Health Centers 93.78%. The Wilcoxon Signed Rank Test ‘Z’ value 3.29 indicated significant difference between urban and rural area at p <= 0.01 level. Hence, the recording was better in the urban area. Outcome of the study is the nursing (RCH) audit tool to assess RCH services provided by FHWs which is valid, reliable, practicable acceptable and usable.
Audit, Reliability, Validity, Item Analysis, Retrospectives, Prospective
