Author: Ho, Wai Ching Trudy
Title: Clinical audits among nurses in Hong Kong: scale development and normative profiles
Advisors: Shek, Daniel (APSS)
Degree: DHSc
Year: 2015
Subject: Medical audit
Nurses -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: xv, 374 pages : color illustrations
Language: English
Abstract: Although clinical audit plays a key role in improving the quality of patient care, no scientific study or appropriate measurement of nurses' views on clinical audits has been conducted in Hong Kong. This study had several objectives. First, a scale was constructed to assess nurses' perceptions of different characteristics of clinical audit. Second, the psychometric properties of the developed scale were examined. Third, normative profiles of different domains of clinical audit were described. Finally, seven sets of hypotheses were tested. Method: A 115-item scale covering 12 key domains of clinical audit was developed based on a literature review and observations of clinical audit practice in hospitals. In the main study, 562 nurses from 4 public hospitals and 7 private hospitals responded to the scale in a self-administered manner. The total scale and the subscales, based on the different domains, were internally consistent and supported the construct validity of the related measures. Results: Based on the views of nurses and experts in the field, the results showed that the scale had high content validity. Several observations can be highlighted from the responses to the scale items in the overall sample of nurses as follows: a) most nurses were familiar with the purpose of clinical audit and were aware that clinical audits were commonly practiced in Hong Kong (knowledge); b) the nurses generally regarded clinical audit as a quality improvement process (meaning); c) the majority of nurses believed that clinical audits improved patient safety and clinical practice (benefits); d) some nurses perceived that there was insufficient hospital support for clinical audits (perceived hospital support); e) some nurses expressed concerns about clinical audit as merely being a method of obtaining data to check the compliance to standards and that it was a top-down process imposed on staff (concerns); f) the majority of nurses reported that they would participate in clinical audits because they comprised an effective quality improvement tool (readiness); g) the most important perceived factors for effective clinical audits included the provision of clear guidelines, adequate manpower, and sufficient time (perceived determinants for success); and h) although most nurses had positive attitudes about clinical audit, some negative attitudes were observed (attitudes). Similar findings were found for nurses who had experienced clinical audit. These nurses also perceived the benefits of clinical audits for the institution and themselves. The results also showed that meaning, perceived benefits, hospital support, and concerns were significant predictors of nurses' attitudes toward clinical audit. Perceived benefits, hospital support, concerns, and attitudes also predicted nurses' readiness to engage in clinical audit. Nurses with clinical audit experience reported more positive attitudes, more positive meaning, fewer concerns, and a greater readiness to engage in clinical audit than nurses without experience. Conclusion: This is the first known Chinese study in this field. The findings highlight the perceived benefits of clinical audit and enhance our understanding of nurses' experiences of the clinical audit process in Hong Kong. A useful instrument for assessing clinical audits was also developed, which has both research and practical significance.
Rights: All rights reserved
Access: restricted access

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