A typology of knowledge for district nursing assessment practice.

Abstract

This paper reports on part of a larger study, the aim of which was to explore the nature of knowledge required by district nurses (DNs) to carry out first assessment visits, and the relationship of this to the decisions they make. Assessment of need is a key and complex component of the DN role. To date, there has been limited exploration of the knowledge underpinning needs assessment in district nursing practice. The aim of this paper is to identify and categorize the knowledge in use by DNs undertaking first assessment visits, by presenting it in the form of the typology of knowledge which emerged from the study. The study used a qualitative, ethnographic design. Eleven DNs were observed undertaking first assessment visits and interviewed twice: following the observed visit and 1 year later, after preliminary data analysis had been undertaken. Approaches to analysis were data driven, and constructing the typology involved uncovering and linking what the DN was seeing, asking and doing. Data were collected during 1997 and 1998. The findings revealed a breadth and depth of community nursing knowledge that seemed to incorporate an amalgam of theoretical (knowing that) and practice-based (knowing how) knowledge. The findings depict the range and scope of the knowledge in use by the DNs, and challenge the utility of theoretical models that remove knowledge from the context in which it is used and applied. The findings presented here provide fresh insight into the 'know-how' of district nursing assessment practice. Whilst the typology requires further testing and refinement in order to enhance understanding of practice, it conceptualizes aspects of district nursing assessment knowledge and addresses the current lack of underpinning principles in district nursing practice.