Thomas LM, Reynolds T, O'Brien L. Innovation and change: shaping district nursing services to meet the needs of primary health care.
J Nurs Manag 2006;
14:447-54. [PMID:
16919122 DOI:
10.1111/j.1365-2934.2006.00686.x]
[Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND
National Health Service reforms and government directives have placed primary care in the forefront of health care provision. Robust information is needed to inform and direct the district nursing response to these initiatives.
AIM
To gain a detailed understanding of the district nursing service in the West Hertfordshire area, determine capacity for development and formulate plans for the 21st century.
METHODS
Action research was the supporting methodology. A project group of working professionals led the study, identifying several areas for development, of which two are discussed: workload measurement and caseload profiling.
KEY FINDINGS
An understaffed service with unpredictable workload which mitigates against proactive working. The inappropriate use of staff skills prevents efficient, cost-effective care.
CONCLUSIONS
Robust caseload management with strict referral and discharge criteria and prioritization of visits offers the possibility of more effective time management. Skill mix review could enable more appropriate use of specialist skills.
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