Community Nursing Care for Clients with Chronic and Complex Conditions

Abstract

This study describes community-based clients with chronic and complex conditions and the nursing care they received from community nurses in an area health service in western Sydney. Information from an existing database of occasions of service was de-identified and analysed to identify client characteristics and types of nursing care, community nurses had provided in the period mid-2003 and mid-2004. Main findings were 77% of occasions of service were received by clients who were 60 years with 42% of these being to the 80 years and over age group; overall ‘wound care' was the most common occasion of service clients received with ‘follow-up' being markedly higher for clients 80 years and over. Clients with carcinoma received the most occasions of service with the palliative care specialist nurse providing more occasions of service to clients with chronic and complex than other specialist nurses. In conclusion, investigation is required to ascertain more definitively how health is addressed with clients with chronic and complex conditions and to clarify the role of the community nurse in the multidisciplinary team. Further, a more sensitive categorisation system that specifically describes the direct components of clinical care given by community nurses able to be accessed by client not just occasion of service needs to be developed and implemented.