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There is a global shortage of nurses, leading many countries to recruit internationally qualified nurses (IQNs) to fill the gap. However, IQNs encounter challenges in integrating into their new professional environment, particularly in their interactions with locally qualified nurses (LQNs). Intraprofessional cultural competence (IPCC), defined as 'a set of congruent behaviours and attitudes that enable professionals to work respectfully and effectively in cross‐cultural situations', may be a strategy to address these challenges. Content analysis was used to examine nursing regulatory documents (Standards for Practice [Standards] and Codes of Conduct [Codes]) from the United Kingdom, New Zealand and Australia. Data were extracted and organised based on four key themes relevant to IPCC. The analysis revealed a focus on 'Mutual collaboration and professional relationships' in six regulatory documents, with explicit commitments to preventing racism and discrimination in the Australian and NZ Codes. However, issues such as racism, discrimination, bullying and harassment faced by IQNs are not comprehensively addressed, as the documents mainly prioritize culturally appropriate patient interactions over relationships between colleagues. Using regulatory documents to address IPCC may influence positive change such as improving communication, and preventing racism, bullying, discrimination and harassment within nursing. [ABSTRACT FROM AUTHOR]

Aims Background Introduction Methods Results Discussion Conclusion and implications for nursing and health policy To explore the experience of registered nurses and their mentors in the implementation of the Gerontological Nursing Competencies in long‐term aged care and the perceived effectiveness and suitability of the programme to support nurse development.The global population is ageing and needs a reliable aged‐care nursing workforce.Opportunities for education and mentorship for newly qualified and experienced aged‐care nurses warrant investigation.Qualitative evaluation using semi‐structured focus groups was conducted following the implementation of the programme into five not‐for‐profit long‐term aged‐care organisations and analysed by a reflexive qualitative thematic approach and reported according to COREQ criteria.A total of 21 nurses (7 mentors and 14 mentees) participated in six focus groups. Five themes were generated: (1) nurses gained confidence and competence through the programme; (2) the facilitation of suitable mentoring activities and approaches was crucial to success; (3) the programme helps nurses recognise gerontology as a specialty; (4) the programme contributes to building a strategy of recruitment/retention/quality improvement in the sector; (5) barriers, challenges, changes and recommendations were identified.The Gerontological Nursing Competency model, which combined adaptive mentoring supported by reflective practice embedded in a gerontological nursing competencies framework, was perceived to improve nurse confidence and competence to lead and improve nursing standards of care.The evidence‐based competencies are an acceptable and effective method for supporting gerontological nurse development. Expansion of, and accessibility to, the programme may aid global responses to aged‐care reform, by building the recognition of gerontological nursing as a specialty and contributing towards recruitment, retention and quality care improvements. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses and nursing knowledge contributed to the success of an Australian nurse‐led medical hotel quarantine facility during the COVID‐19 pandemic. The facility was established to accommodate returning travellers who were COVID‐19 positive or at risk of becoming positive, to travellers requiring complex care and expanded to community members who could not quarantine at home. Design: This descriptive qualitative study explored how nurses and nursing knowledge in the quarantine facility contributed to the low transmission incidence of COVID‐19 infection. Method: Twelve semi‐structured interviews were conducted via ZOOM from February to May 2022 with all levels of nursing staff (nurse managers to assistants in nursing) who had worked in the facility for 3 months or more. The nurses were asked to describe their experiences, the challenges they faced and how they overcame them. The data were rich and were analysed using Braun and Clarke's six‐step thematic analysis. Results: Four broad themes were generated demonstrating how nurses played a pivotal role in the success of the facility. First: nursing knowledge was evident through the development of policies, which minimized risks to nurses and patients. Second: a community of learning was developed as nurses supported upskilling and capacity building of staff, particularly new graduates with the facility. Third: a supportive management structure promoted teamwork and a positive workplace culture. And finally: the nurses were encouraged to develop techniques that promoted self‐care which enabled them to develop resilience. Conclusion: This was a nurse‐led service that developed strategies to manage care delivery and overcame unanticipated difficulties in a unique clinical setting. Reporting Method: The quality of the research design was ensured by using the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Research Objective: The aim of this article is to report a study that explores how spirituality is understood to be represented in the current Australian Nursing and Midwifery Board of Australia (NMBA) Registered Nurse (RN) standards for practice. Research Design: Fairclough's approach to critical discourse analysis was applied in the examination of participant interview texts for the language used in relation to spirituality as well as power mechanisms which influenced the way the participants viewed spirituality's representation in the RN Standards for Practice. Participants: Three members of the RN Standards for Practice research and development team. Results: Findings indicate three discourses shaped the way participants viewed how spirituality is presently represented in the RN Standards for Practice. Discourses are (1) spirituality as part of holistic care, (2) spirituality as part of person-centered care, and (3) the professionalization of nursing. Conclusions: Participant interviews revealed these discourses exerted power over how spirituality was represented within the RN Standards for Practice. This has implications for the inclusion of spirituality in the practice standards and the practice of spiritual care. [ABSTRACT FROM AUTHOR]

Aim: To achieve profession‐wide consensus on clinical practice standards for six broad Australian nurse practitioner specialty areas (termed metaspecialties). Design: Sequential mixed methods with initial interpretive study (Interpretive Phase) followed by modified three‐round Delphi study (Survey Phase). Methods: Participants from all Australian jurisdictions were recruited. Main eligibility criterion was current endorsement as a nurse practitioner for 12 or more months. Interpretive Phase comprised in‐depth interviews of purposeful sample of nurse practitioners to identify clinical care activities and practice processes. Six sets of draft clinical practice standards relevant to six previously identified metaspecialties were developed. Outcome informed Round 1 of Survey Phase (six nested web‐based Delphi surveys), with draft standards reviewed profession‐wide. Responses comprised scoring using Likert scales to calculate content validity indexes for individual standards with qualitative responses supporting decision‐making. For Rounds 2 and 3, participants rated relevancy of original or revised standards after consideration of individual and group feedback. The study was conducted 2014–2017. Results: Interpretive Phase: Analysis of interview data with 16 nurse practitioners provided 75 draft standards. Survey Phase: 221 nurse practitioners completed Round 1 (20% of then eligible Australian nurse practitioners). Weighted respondent retention was 92%. Seventy‐three standards were validated, with final content validity indices of 92–100%. Scale‐level indices were 98%, strongly validating metaspecialty taxonomy. Conclusion: A research‐derived, professionally endorsed suite of nurse practitioner clinical practice standards was developed. This provides a broad clinical learning structure with metaspecialties guiding nurse practitioner student clinical education. Impact: The clinical practice standards and metaspecialty taxonomy strengthen nurse practitioner clinical education and professional development nationally and internationally. These novel study methods and findings are applicable to advanced specialty roles in other health professions. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is a trend in higher education towards the use of digital or electronic portfolios (ePortfolios) to collect evidence that demonstrates learning and skill development. There are very few papers that examine the key features and what to include in an occupational therapy ePortfolio. OBJECTIVE: This study presents an approach to developing a graduate entry ePortfolio to prepare occupational therapy students for transition to work. METHODS: An e-Delphi approach was used to gather the opinions of eight categories of experts. Three rounds of questionnaires were used to explore the purpose, terminology, content, structure, and development phases of a graduate entry ePortfolio. RESULTS: Key stakeholders indicated that the purpose of a professional portfolio is to create a professional profile, record experiences, skills and behaviours, and promote recording of lifelong learning and achievements. Delphi expert panel members emphasised the importance of personal choice in selecting evidence recorded in each collection, which must be guided by ethical decision-making. CONCLUSIONS: The findings of the study are important to students who wish to build an ePortfolio to organise and display evidence of competence prior to graduation in readiness to enter the workforce. The recommendations also will be of value to occupational therapy educators in curriculum development. [ABSTRACT FROM AUTHOR]

Aims: To explore the perceptions of Australian nurses working in disability‐specific settings and/or roles, about: (a) nursing people with intellectual and developmental disability living in Sydney; and (b) the utility and applicability of professional practice standards designed specifically for intellectual and developmental disability nursing. Design: A qualitative research design was used to guide the study and our analysis utilized the constant comparative approach to thematic data analyses. Methods: Individual in‐person interviews were conducted with 18 nurses working in intellectual and developmental disability‐specific settings and/or roles across the state of New South Wales between July – December, 2017. Participants described what it is that sets intellectual and developmental disability nursing apart from other nursing specialties, and the rewards and challenges of their role. Questions were also asked about professional practice standards in general and more specifically intellectual and developmental disability professional practice standards. Data were analysed thematically. Findings: Three themes reflected intellectual and developmental disability nurses' perceptions: (a) a unique investment in the nurse/patient dyad; (b) a bridge between disparate systems; and (c) an ambiguous future. Nurses reported variable understanding of professional practice standards designed for intellectual and developmental disability nursing, but also a belief in their importance. Conclusion: The intellectual and developmental disability nurses' experience of care accounts for the specific needs of patients with intellectual and developmental disability and suggests the importance of professional practice standards which acknowledge the changing landscape of care in Australia prompted by the implementation of the National Disability Insurance Scheme. [ABSTRACT FROM AUTHOR]

Aim To develop a framework for emergency nursing transition to specialty practice programmes. Background Transition to Specialty Practice programmes were introduced to fill workforce shortages and facilitate the transition of nurses to specialty nursing practice. These programmes are recognized as an essential preparation for emergency nurses. Emergency nursing Transition to Specialty Practice programmes have developed in an ad hoc manner and as a result, programme characteristics vary. Variability in programme characteristics may result in inconsistent preparation of emergency nurses. Design Donabedian's Structure-Process-Outcome model was used to integrate results of an Australian study of emergency nursing Transition to Specialty Practice programmes with key education, nursing practice and safety and quality standards to develop the Transition to Specialty Practice (Emergency Nursing) Framework. Methods An explanatory sequential design was used. Data were collected from 118 emergency departments over 10 months in 2013 using surveys. Thirteen interviews were also conducted. Comparisons were made using Mann-Whitney U, Kruskal-Wallis and Chi-square tests. Qualitative data were analysed using content analysis. Results Transition to Specialty Practice programmes were offered in 80 (72·1%) emergency departments surveyed, to improve safe delivery of patient care. Better professional development outcomes were achieved in emergency departments which employed participants in small groups ( Median = 4 participants) and offered programmes of 6 months duration. Written assessments were significantly associated with articulation to postgraduate study (Chi-square Fisher's exact P = <0·001). Conclusion The Transition to Specialty Practice (Emergency Nursing) Framework has been developed based on best available evidence to enable a standardized approach to the preparation of novice emergency nurses. [ABSTRACT FROM AUTHOR]

Background: The rapid growth in the use of mobile technology in Australia has outpaced its governance, especially in healthcare settings. Whilst some Australian professional bodies and organisations have developed standards and guidelines to direct appropriate use of social media and mobile technology, clear governance arrangements regarding when, where and how to use mobile technology at point of care in nursing are currently lacking. Discussion: This paper analyses how the use of mobile technology by nurses at point of care is governed. It highlights the existence of a mobile technology paradox: an identified inability of nurses to access mobile technology in a context where it is increasingly recognised that its use in situ can enhance nursing practice while contributing to mobile learning and continuing professional development. While the recent release of the Registered Nurse Standards for Practice and accompanying Standard for Continuing Professional Development provides some direction regarding professional standards to support the use of mobile technology for mobile learning, we argue a more inclusive approach is required if emerging technologies are to be fully embraced. We describe how an implementation framework, underpinned by more detailed standards, guidelines and codes, could enable the nursing profession to be leaders in embedding mobile technology in healthcare environments nationally and globally. Conclusion: The prevalence of mobile technology in Australia has outpaced its governance in healthcare environments. Its limited availability at point of care is hindering nursing practice, mobile learning and continuing professional development. We discuss the emergence of mobile technology and impediments for its use by nurses in situ. We analyse the professional codes governing nursing, outlining potential reforms to enable implementation of mobile technology at point of care by nurses. [ABSTRACT FROM AUTHOR]

Background: Reports into neglect by nursing staff have included recommendations to develop policies indicating the fundamental standards of care (Garling, 2008; Francis, 2013). An area health service in a rural setting in Australia moved to develop such a policy. Objectives: This project was designed to engage nursing staff in a rural health service in the development of a minimum nursing standards policy. Methods: A participatory action research methodology was used to engage with nursing staff. A thematic analysis of focus group meetings was conducted to identify themes. Findings: Though discussions in focus groups did function to develop the policy, participants also expressed views on issues of nursing within the organisation. Themes were identified as either personal or organisational. Personal features included lack of motivation and burnout in staff. Organisational features were controlled by the organisation and included features such as a lack of time and autonomy to commit to the project. [ABSTRACT FROM AUTHOR]

The nursing practice environment is an important factor for services to consider in the attraction and retention of a skilled workforce during future nursing shortages. Despite the significant number of international studies undertaken to understand the influence of the practice environment on nurse satisfaction and retention, few have been undertaken within the mental health setting. This paper reports on results from a survey conducted in a large Australian public mental health hospital to examine nurses' perceptions of their practice environment, and identifies interventions that could be implemented to improve the practice environment. The hospital is the only remaining, standalone public mental health hospital in Western Australia. [ABSTRACT FROM AUTHOR]

Purpose: Many haematological cancer survivors report long-term physiological and psychosocial effects beyond treatment completion. These survivors continue to experience impaired quality of life (QoL) as a result of their disease and aggressive treatment. As key members of the multidisciplinary team, the purpose of this study is to examine the insights of cancer nurses to inform future developments in survivorship care provision.Methods: Open text qualitative responses from two prospective Australian cross-sectional surveys of nurses (n = 136) caring for patients with haematological cancer. Data were analysed thematically, using an inductive approach to identify themes.Results: This study has identified a number of issues that nurses perceive as barriers to quality survivorship care provision. Two main themes were identified: the first relating to the challenges nurses face in providing care ('care challenges') and the second relating to the challenges of providing survivorship care within contemporary health care systems ('system challenges').Conclusions: Cancer nurses perceive the nature of haematological cancer and its treatment and of the health care system itself, as barriers to the provision of quality survivorship care. Care challenges such as the lack of a standard treatment path and the relapsing or remitting nature of haematological cancers may be somewhat intractable, but system challenges relating to clearly defining and delineating professional responsibilities and exchanging information with other clinicians are not.Implications For Cancer Survivors: Addressing the issues identified will facilitate cancer nurses' provision of survivorship care and help address haematological survivors' needs with regard to the physical and psychosocial consequences of their cancer and treatment. [ABSTRACT FROM AUTHOR]

With the commodification of healthcare in general and of private health in particular, it is difficult not to acknowledge the growing influence of competition and 'the market' in shaping the way that nurses' work is managed by private hospitals and by nurses themselves. This paper explores the discourses shaping nurses' work in private healthcare, drawing upon data from an ethnographic study conducted in one Australian acute care private hospital. The framework for analysis relies on an exploration of the mentalities and governance of nurses' work in such a setting. The study shows how marketing and performance measures are believed to ensure the viability of the enterprise while simultaneously commodifying nurses' caring work. It is this work that remains invisible to the healthcare system and the hospitals where they work. [ABSTRACT FROM AUTHOR]

Focuses on the implications of international convergence of health and higher education policy for nursing education in Australia. Basis of the trend toward convergence; Common response of countries to improve health condition and access to care; Future scenario for nursing education.

In this very critical evaluation of the value and effectiveness of nursing audits, the author shares information about the state of nursing in Australia, gleaned from a recent study. Some myths about nursing practice are debunked. The stark reality is discussed and analysed and a direction for the future is suggested. Although the paper relates exclusively to Australia, its contents will undoubtedly ring true in many other countries. The dichotomy between nursing education and nursing service is considered at length. As are the resulting conflicts of nursing students, clinical instructors and nurse tutors. Teachers of nursing appear to decry the need for them to be clinically involved, as a result nursing education is less meaningful. A particularly strong plea is made for adequate inservice education programmes and a more flexible and thorough approach to change, free from undue commitment to the past. [ABSTRACT FROM AUTHOR]

Introduction: The Australian Council on Healthcare Standards (ACHS) set criteria for the delivery of healthcare services in Australia. While a voluntary process, continual accreditation with ACHS is an expectation of, and for, Australian healthcare providers. Juxtapositioned with the ACHS, the Nursing and Midwifery Board of Australia (NMBA) set the mandatory practice requirements of, and for, Australian nurses. Despite these overarching quality and governance directives, a regional Queensland Hospital and Health Service (HHS) demonstrated deficits in the quality of nursing care. Accordingly, a HHS project was commissioned with the aim of producing a quantum shift in the quality of nursing services such that the service was ready-everyday for accreditation assessment, and nursing practice exemplified the NMBA standards.Several barriers to achieving the aim were identified and it was considered that the implementation of critical system changes would structurally and operationally support the achievement of the aim. The system changes are pivoted around an interactive matrix that links nursing care services to the array of nursing professional and practice standards and provides real-time quantitative output measures. This paper outlines the protocol that will be used to establish, implement and evaluate the matrix., Methods and Analysis: A participatory action research design with a modified Delphi methodology will be used for the development the matrix. The organisational change management around the matrix implementation will be informed by Kotter's model and supported by the use of the McKinsey 7S. The matrix implementation phase will be conducted using a modified Promoting Action on Research Implementation in Health Services model. Quantitative and qualitative data will be collected over a 12 month pre-test/post-test design to measure the statistical significance of the matrix in supporting compliance with nursing standards and the achievement of quality nursing care. Quantitative data from quality of care assessments will be analysed using descriptive and comparative statistics. Qualitative data from staff surveys will be analysed by content analysis of the major themes (n~200)., Ethics and Dissemination: The project has ethics approval from a Queensland Health Human Research Ethics Committee. Results will be reported to participants and other stakeholders at seminars and conferences and through peer-reviewed publications., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Home visiting programs are implemented in high income countries to improve outcomes for families with young children. Significant resources are invested in such programs and high quality evaluations are important. In the context of research trials, implementation quality is often poorly reported and, when reported, is variable. This paper presents the quality of implementation of the right@home program, a sustained nurse home visiting intervention trialled in Australia, and delivered in a 'real world' context through usual child and family health services. right@home is structured around the core Maternal Early Childhood Sustained Home-visiting (MECSH) program, which is a salutogenic, child focused prevention model., Method: At each visit right@home practitioners completed a checklist detailing the client unique identifier, date of contact and activities undertaken. These checklists were collated to provide data on intervention dose, retention to program completion at child age 2 years, and visit content, which were compared with the program schedule. Quality of family-provider relationship was measured using the Session Rating Scale. Exploratory factor analysis was conducted to identify clusters of activities and allow qualitative assessment of concordance between program aims and program delivery., Results: Of 363 intervention families offered the program, 352 (97·0%) commenced the program and 304 (87·3%) completed the program to child age 2 years. 253 of 352 (71·9%) families who commenced the program received more than 75 percent of scheduled visits including at least one antenatal visit. Families rated the participant-practitioner relationship highly (mean 39.4/40). The factor analysis identified six antenatal and six postnatal components which were concordant with the program aims., Conclusions: The right@home program was delivered with higher adherence to program dose, schedule and content, and retention than usually reported in other home visiting research. Program compliance may have resulted from program design (visit schedule, dose, content and delivery flexibility) that was consistent with family aims., Competing Interests: The authors have declared that no competing interests exist. The MECSH® program is a registered trademark of UNSW Australia and from 2016 for the duration of 5 years is being sublicensed to Western Sydney University. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: Workplace-based learning and assessment are essential elements of all nursing education programs. There is, however, limited evidence of validity and reliability available regarding assessment instruments, based on the professional competency standards for nursing in Australia., Objective: The aims of this project were to advance the assessment properties of a new instrument, the Australian Nursing Standards Assessment Tool (ANSAT) and investigate the acceptability of this instrument when applied to the evaluation of the professional competence of nursing students in authentic practice settings., Methods: A validation study of ANSAT was conducted by 23 clinical assessors from two universities, completing 220 instruments for second and third year undergraduate nursing students undertaking clinical placement in an authentic practice setting. 'Think Aloud' interviews and a post-test survey provided additional data to determine the validity and acceptability of the ANSAT. The pilot study occurred in parallel with completion of existing university assessment instruments., Results: Principal components analysis extracted one factor: professional practice competence. Comparison of total instrument scores between year levels demonstrated a significant difference in each of the clinical domains (p=0.000), suggesting that the instrument is sensitive to differing levels of performance across different year levels. The ANSAT demonstrated high internal consistency with a Cronbach's alpha coefficient of 0.976. Post-test evaluation completed by assessors demonstrated high usability and acceptability for use in common practice settings., Discussion: Results of the pilot study provided preliminary support for the ANSAT instrument. It is recommended that testing of the instrument be undertaken on a larger cohort to ensure the generalisability of the findings to other nursing populations., Conclusion: There is a need for valid and reliable instruments that assess the performance of nursing in the authentic practice setting. With the addition of supportive behavioural cues, the ANSAT enables clarity, consistency and collaboration in workplace-based assessment., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Nursing practice is a dynamic and constantly changing field within healthcare, with well-documented challenges to maintaining a suitably skilled workforce to meet the needs of the community it serves. Undergraduate nursing education provides the mandatory minimum requirements for professional registration. Each nursing program has clearly stated graduate attributes, qualities that their graduates will possess on graduation. The aim of this paper is to stimulate discussion about graduate attributes for nurses, a transferrable set of specific attributes that make nursing graduates work ready. This paper focuses on identifying specific attributes, the embedding of those attributes in nursing education, particularly through role modelling, with the aim of producing a future workforce that is knowledgeable, compassionate and confident. The graduate attributes are likened to the qualities sought by the characters in 'The Wizard of Oz'; brains, heart and courage and the learning process as the 'Yellow Brick Road'. There is a relative lack of discussion about role modelling by nurse educators for nursing students, a potentially undervalued learning experience that we believe must be brought to the forefront of discussions pertaining to undergraduate nursing education and achieving graduate outcomes., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Presents an overview of the statement issued by the Royal Australian Nursing Federation on the standards of nursing care in Australia. Reasons behind the deterioration of nursing care standards; Increase in the use of untrained medical personnel in the delivery of patient care; Actions to be taken by the group to resolve the problem.

The last two decades have seen a significant restructuring of work across Australia and other industrialised economies, a critical part of which has been the appearance of competency based education and assessment. The competency movement is about creating a more flexible and mobile labour force to increase productivity and it does so by redefining work as a set of transferable or 'soft' generic skills that is transportable and is the possession of the individual. This article sought to develop an analysis of competency based clinical assessment of nursing students across a bachelor of nursing degree course. This involved an examination of a total of 406 clinical assessment tools that covered the years 1992-2009 and the three years of a bachelor degree. Data analysis generated three analytical findings: the existence of a hierarchy of competencies that prioritises soft skills over intellectual and technical skills; the appearance of skills as personal qualities or individual attributes; and the absence of context in assessment. The article argues that the convergence in nursing of soft skills and the professionalisation project reform has seen the former give legitimacy to the enduring invisibility and devaluation of nursing work., (© 2011 Blackwell Publishing Ltd.)

Background: The past few years has seen a growth in the number of new nursing roles and position titles in many countries, including Australia. The Australian situation is unique due to the lack of professional engagement and debate in determining the purpose of some of these new positions. Often these new roles have been poorly defined, and there is no national consistency in nomenclature. The recent move to a national nursing registration system provides an opportunity for change., Method: Discursive paper., Results: New roles arise for a number of reasons, including a change in function or title for a preexisting role or in response to the establishment a completely new position. However, the lack of a co-ordinated approach to introduction of new roles may lead to role proliferation (the rapid increase or spread of new positions and position titles), role blurring (where the boundaries of different positions become less distinct) and role confusion (where both nurses and health system clients experience a lack of clarity regarding the precise scope of roles)., Conclusion: Professional nursing practice is defined by the impact on patient outcomes, not by position titles. As such, the potential positive impact of a new role on patient outcomes should be the primary consideration when considering its introduction. National regulation of the profession provides an opportunity for the profession to debate and determine some consistency in position titles, responsibilities and areas of specialty practice.

Background: The Nursing and Midwifery Content Audit Tool (NMCAT) was developed to monitor the quality of nursing documentation., Methods: A health care record audit was conducted on 200 records. Using a time-sampling approach, recent nursing documentation was examined. Inter-rater reliability was determined at 85% agreement between two raters., Results: The NMCAT criteria relating to the recording of the patients' health status, use of objective information and logical presentation were met to a high level. The patients' response to treatment or nursing interventions including medications requires attention. The recording of events immediately after they have occurred was limited. The structure of the sentences and language used, restricted the readability of the documentation. The widespread use of local abbreviations, often connected together to form the text, was problematic., Conclusions: The present study provides new audit solutions based on time-sampling approaches and focused evidence-based criteria. The use of language support software and writing coaches to improve the presentation of nursing documentation is recommended., Implications for Nursing Management: The NMCAT is a time-efficient tool available to managers for monitoring the quality of nursing documentation, either at a unit level or across health facilities to demonstrate compliance with quality standards., (© 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.)