Effect of Nursing Audit Feedback on the Documentation of Nursing Care Actions in a Tertiary Hospital in the Southeastern Nigeria: A Quasi-Experimental Study

Abstract

Accurate nursing documentation is essential for maintaining continuity of care, ensuring patient safety, and evaluating nursing performance. However, documentation practices remain suboptimal in many healthcare settings. Nursing audit feedback interventions have been widely used to improve clinical practice, yet their effectiveness in improving nursing documentation remains insufficiently explored in low-resource healthcare systems. This study evaluated the effect of nursing audit feedback intervention on the documentation of nursing care actions in in a tertiary hospital in the Southeastern Nigeria. A quasi-experimental pre- and post-intervention study was conducted in the federal tertiary hospital. One hundred and fifty patient care folders from medical and paediatric wards were selected using quota sampling. Documentation of 28 nursing care actions was assessed using a validated Nursing Action Audit Checklist. Baseline documentation was evaluated prior to the intervention, followed by the implementation of a structured audit feedback intervention. Post-intervention documentation was assessed two months later. Data were analyzed using descriptive statistics, Chi-square tests, and relative risk estimation at a significance level of p < 0.05. Findings indicated that only 6 of 28 nursing care actions (21.4%) were adequately documented. Following the audit feedback intervention, adequate documentation increased to 24 of 28 actions (85.7%). Statistical analysis demonstrated a significant improvement in documentation practices (χ² = 23.26, p < 0.001). The intervention increased the likelihood of adequate documentation by approximately fivefold (RR = 5.50, 95% CI: 2.17–13.91). In conclusion, nursing audit feedback significantly improved the documentation of nursing care activities in the study setting.