Auditoria de enfermagem como ferramenta estratégica de gestão: contribuições para a sustentabilidade financeira das instituições de saúde

Financial sustainability is one of the major challenges in hospital management, and nursing auditing can contribute to addressing this issue. This study aimed to analyze nursing auditing as a strategic management tool and its contributions to the financial sustainability of healthcare institutions. This is a narrative literature review with a qualitative approach, encompassing studies on the role of nurse auditors, the use of hospital resources, the prevention of claim denials, and the legal framework governing the profession. The findings indicate that deficiencies in clinical documentation and billing processes can result in significant financial losses. In a private hospital, 45,364 denied items amounted to BRL 331,245.00, of which 49% were related to the nursing team. In a hemodynamics service at a public hospital, underbilling was identified across the item groups analyzed, primarily associated with missing documentation in medical records, inconsistencies in the quantities billed, and errors in item registration, particularly concerning orthoses, prostheses, and special medical materials (OPME). Professional regulation, including Law No. 7,498/1986 and COFEN Resolutions No. 720/2023 and No. 733/2023, provides the legal basis for the practice of nursing auditing. It is concluded that nursing auditing integrates clinical, administrative, and financial dimensions, contributing to cost control, the prevention of claim denials, and the appropriate use of hospital resources. The main limitation of this study is the narrative nature of the review, which did not follow systematic search criteria, highlighting the need for further studies in different hospital settings.