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Harper-McDonald B. District nurses' experiences with a caseload profiling tool: a service evaluation. Br J Community Nurs 2020; 25:318-326. [PMID: 32614664 DOI: 10.12968/bjcn.2020.25.7.318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Caseload profiling is being advocated as a method to measure, manage and evidence increasingly complex caseloads in district nursing. However, there is no qualitative work on district nurses' experiences of applying caseload profiling to their caseloads. The aim of the service evaluation presented in this paper was to explore a working group's experiences of implementing a caseload-profiling tool to caseloads in district nursing in one community setting. As part of the service evaluation, three semi-structured interviews were conducted during meetings of the working group. Following data collection, thematic analysis supported the identification of three themes: barriers, facilitators and significance of data collected from caseload profiling. Subthemes were identified and compared with available literature and policy to enable new insights from practitioners to be gained. The service evaluation concluded that caseload profiling is a simple process that yields rich, complex data, with the data generated from the caseload profiles providing a method to evidence the complexity of district nursing caseloads and information to support proactive caseload management and identification of service delivery priorities.
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Flo J, Landmark B, Tønnessen S, Fagerström L. Patient classification systems used to classify nursing intensity and assess nursing staffing resources in home health care: A scoping review. Int J Nurs Stud 2019; 99:103361. [DOI: 10.1016/j.ijnurstu.2019.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 11/27/2022]
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McCrory V. Caseload management: a district nursing challenge. Br J Community Nurs 2019; 24:186-190. [PMID: 30969854 DOI: 10.12968/bjcn.2019.24.4.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The district nurse is accountable for the standard of nursing care that is delivered by the team they lead. One of the key challenges in ensuring the provision of a high standard of care is effective caseload management, and caseload management is a core component of the district nursing role. This article highlights the strategic drivers behind community care, outlines the challenges that impact effective caseload management and discusses why effective caseload management is significant in the delivery of community care. It also explores the delegation of workload, triaging referrals, caseload analysis and clinical supervision as methods that the district nurse can use to overcome and manage the challenges that caseload management can present.
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Harper-McDonald B, Baguley F. Caseload profiling in district nursing: a systematic literature review. Br J Community Nurs 2018; 23:544-549. [PMID: 30398917 DOI: 10.12968/bjcn.2018.23.11.544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This systematic literature review aims to identify and appraise current evidence to establish if caseload profiling (CP) provides a strategy to support district nurses to evidence and manage increasingly complex caseloads. A total of 17 studies where thematically synthesised and recurrent themes were identified and summarised under the headings of: defining caseload profiling; caseload profiling in the context of caseload management; workload analysis and its relationship to caseload profiling; potential impact of caseload profiling; and potential barriers to caseload profiling. The literature review showed CP is a robust method of articulating the complexity of care and practitioners could use it to help manage their own caseloads. However, the literature is mainly founded on expert opinion and further research is needed to strengthen the validity of the evidence.
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Affiliation(s)
| | - Fiona Baguley
- Lecturer, Public Health/Community, Robert Gordon University, Aberdeen
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Burton CR, Rycroft-Malone J, Williams L, Davies S, McBride A, Hall B, Rowlands AM, Jones A, Fisher D, Jones M, Caulfield M. NHS managers’ use of nursing workforce planning and deployment technologies: a realist synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundPolicy and reviews of health-care safety and quality emphasise the role of NHS managers in ensuring safe, good-quality patient care through effective staffing. Guidance requires that NHS managers combine professional judgement with evidence-based workforce planning and deployment tools and technologies (WPTs). Evidence has focused on the effectiveness of WPTs, but little is known about supporting their implementation, or the impact of using WPTs across settings.ObjectivesThe review answered the following question: ‘NHS managers’ use of workforce planning and deployment technologies and their impacts on nursing staffing and patient care: what works, for whom, how and in what circumstances?’.DesignA realist synthesis was conducted. A programme theory was formulated and expressed as hypotheses in the form of context, mechanisms and outcomes; this considered how, through using WPTs, particular conditions produced responses to generate outcomes. There were four phases: (1) development of a theoretical territory to understand nurse workforce planning and deployment complexity, resulting in an initial programme theory; (2) retrieval, review and synthesis of evidence, guided by the programme theory; (3) testing and refinement of the programme theory for practical application; and (4) actionable recommendations to support NHS managers in the implementation of WPTs for safe staffing.ParticipantsNHS managers, patient and public representatives and policy experts informed the programme theory in phase 1, which was validated in interviews with 10 NHS managers. In phase 3, 11 NHS managers were interviewed to refine the programme theory.ResultsWorkforce planning and deployment tools and technologies can be characterised functionally by their ability to summarise and aggregate staffing information, communicate about staffing, allocate staff and facilitate compliance with standards and quality assurance. NHS managers need to combine local knowledge and professional judgement with data from WPTs for effective staffing decisions. WPTs are used in a complex workforce system in which proximal factors (e.g. the workforce satisfaction with staffing) can influence distal factors (e.g. organisational reputation and potential staff recruitment). The system comprises multiple organisational strategies (e.g. professional and financial), which may (or may not) align around effective staffing. The positive impact of WPTs can include ensuring that staff are allocated effectively, promoting the patient safety agenda within an organisation, learning through comparison about ‘what works’ in effective staffing and having greater influence in staffing work. WPTs appear to have a positive impact when they visibly integrate data on needs and resources and when there is technical and leadership support. A collaborative process appears to be best for developing and implementing WPTs, so that they are fit for purpose.LimitationsThe evidence, predominantly from acute care, often lacked detail on how managers applied professional judgement to WPTs for staffing decisions. The evidence lacked specificity about how managers develop skills on communicating staffing decisions to patients and the public.Conclusions and recommendationsThe synthesis produced initial explanations of the use and impact of WPTs for decision-making and what works to support NHS managers to use these effectively. It is suggested that future research should further evaluate the programme theory.Study registrationThis study is registered as PROSPERO CRD42016038132.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Christopher R Burton
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | - Jo Rycroft-Malone
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | - Lynne Williams
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | - Siân Davies
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | - Anne McBride
- Alliance Manchester Business School, University of Manchester, Manchester, UK
| | - Beth Hall
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | | | - Adrian Jones
- Betsi Cadwaladr University Health Board, Bangor, UK
| | - Denise Fisher
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | - Margaret Jones
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
| | - Maria Caulfield
- School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Bangor, UK
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McComiskey F. The fundamental managerial challenges in the role of a contemporary district nurse: A discussion. Br J Community Nurs 2017; 22:489-494. [PMID: 28956968 DOI: 10.12968/bjcn.2017.22.10.489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article examines some of the fundamental challenges facing the district nurse in delivery of the managerial aspects of her role in contemporary practice. It discusses the personal attributes that are essential for this role to ensure safe, effective and compassionate leadership and management. The communication skills and ethos underpinning collaborative multidiscilplinary team work and person-centred care are discussed. Issues that compromise positive and productive team working are identified, and strategies dealing with conflict and also change management are debated. These factors are interrelated with the everyday demands of caseload management, the development of educational needs to meet the demands of increased complexity in care needs, and the place of technology in modern health care. It is evidenced that sustained organisational support for this role is more important than ever, due to increasing demand and decreasing capacity. Potential solutions to these challenges are offered to assist the contemporary district nurse.
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