Registered Nurses provide direct and indirect nursing care to

patients, whether working in a hospital, office, health care

facility,

public

services,

or

home

health

care.

But

before

delivering a good service to patients and become a registered

nurse, student nurses must first undergo with the stages of
becoming a competent nurse such as skills laboratory, competency
appraisal and the hardest part, the licensure examination for
nursing.
Becoming

registered

nurse

requires

college

study

and

licensing examination. While there are discussions of raising the

educational

requirements

to

include

bachelor's

degree,

the

current rules require only some post-secondary study in one of

the nearly 5,000 nursing programs around the world. All graduates
from either diploma or degree programs must write examinations
set by their nurses' association in order to obtain registration.
Most nursing associations recommend that students pursue a degree
in nursing rather than a diploma. It will qualify them for better
job opportunities, as well as provide them with a good education
to prepare them to be a competent nurse in the field they want to
work in.
Nursing audit is an evaluation of nursing service. Before 1955
very little was known about the concept. It was introduced by the
industrial concern and the year 1918 was the beginning of medical
audit. George Groword, pronounced the term physician for the
first time medical audit. Ten years later Thomas R Pondon MD
established a method of medical audit based on procedures used by
financial account. He evaluated the medical care by reviewing the
medical records. First report of nursing audit of the hospital

published

in

1955.

For

the

next

15

years,

nursing

audit

is

reported from study or record on the last decade. The program is

reviewed

from

record

nursing

plan,

nurses

notes,

patient

condition, nursing care. Purposes of Nursing Audit 1. Evaluating

Nursing care given, 2. Achieves deserved and feasible quality of
nursing care, 3. Stimulant to better records, 4. Focuses on care
provided and not on care provider, 5. Contributes to research.
Competency appraisal deals with the application of the concepts,
principles and processes basic

to the

practice of nursing with

emphasis on health promotion, health maintenance, preventive,

risk reduction, curative and rehabilitative aspects of care for
the mother, child, and family, population group and community,
curative and rehabilitative aspects of care sick individual with
alterations in immunologic and inflammatory reactions, cellular
aberrations, perception and coordination, adjustment problems and
maladaptive patterns of behavior, acute biologic crisis, disaster
and

emergency.

It

includes

the

utilization

of

the

nursing

process and the core competencies under the eleven (11) key areas
of the responsibility. These are the important factors during the
course of study to be able to pass the course and preparation for
the licensure examination.
According to Rees (2006) many qualified students accepted into
nursing schools do not graduate. Attrition in nursing programs is
problematic

nationwide.

Generic

students,

licensed

practical

nurse, and paramedic bridge students have a difficult time during

the first semester of nursing school. Students have to adjust to
the rigorous nursing curriculum, which includes preparing for
clinical and course studies (Rees, 2006). In addition, students

are required to take their first drug dosage calculation test and
pass in order to progress to the next semester. Nursing graduates
demonstrate their competency, critical thinking, problem solving,
delegation,
Licensure

and

prioritizing

Examation.

These

skills

by

graduates

passing
will

the

also

Nursing
need

to

demonstrate the minimum knowledge and abilities needed to provide

safe

and

making

effective

skills

nursing

(Norton,

care

Relf,

employing

Cox,

Farley,

critical
Lachat,

decisionTucker,

&

Murray, 2006). An essential component of any nursing program's

success is the pass rate on the NLE for first-time test takers.
Nursing programs with a history of low passing scores for firsttime test takers can have their reputations negatively affected,
possibly

impacting

accreditation.

the

school's

enrollment,

funding,

and