Community Health Care Nursing Research Articles

An integrative review of missed nursing care and the general practice nurse.

The phenomenon of missed care has received increasing interest over the past decade. Previous studies have used a missed care framework to identify missed nursing tasks, although these have primarily been within the acute care environment. The aim of this research was to identify missed care specific to the role of the general practice nurse. An integrative review method was adopted, using The Mixed Methods Appraisal Tool to assist in a methodological appraisal of both experimental, theoretical, and qualitative studies. Thematic analysis was then used to analyse and present a narrative synthesis of the data. CINAHL, SCOPUS, Web of Science and Google Scholar databases were searched between 2011 and 2022 for empirical research that reported missed care and the general practice nurse. Of the 787 papers identified, 10 papers met the inclusion criteria. Three themes identified missed care in relation to primary healthcare nurses: under-staffing and resourcing, communication difficulties, and role confusion. Isolating missed care by general practice nurses was challenging because much of the research failed to separate out general practice nurses from community and primary health care nurses. This challenge was exacerbated by disparity in the way that a general practice nurse is defined and presented in the various databases. While some themes such as those related to communication and understaffing and resourcing demonstrate some parallels with the acute sector, more research is required to identify missed care specific to the general practice nurse.

The ‘Better sleep better well-being’ intervention for parents of infants with moderate sleep problems: A quasi-experimental study

Healthy development of infants/toddlers is associated with adequate parent–child interactions, infant sleep patterns, and infant nutrition. In early childhood, learning to fall and stay asleep is essential and can contribute to infants’ self-regulation and to regulating emotions and behavior. Sleep problems in infancy are, however, of significant concern to parents. This study aimed to research the benefit of a face-to-face family education and support intervention concerning ‘Better sleep better well-being’ (FES-BSBW). Six advanced community healthcare nurses provided three sessions of FES-BSBW intervention to the parents. Data were assessed from 35 primary caregivers. The TREND and TIDieR guidelines were used to report findings. The intervention focused on parent–child interactions and normal child development, temperament, parents’ beliefs about the infants’ sleep patterns, and the impact of the infants’ sleep problems on the parents’ quality of life after the intervention. The intervention was delivered over approximately one month. The primary findings showed that mothers reported significantly higher perceived family support, improved sleep pattern beliefs, better physical functioning and longer infants sleep periods on average at nights after the FES-BSBW intervention. These findings are promising and might prevent sleep problems in infants/toddlers from escalating later into more severe health problems.

Views of learners on prevention and management of pregnancies in schools of Madibeng municipality, North West province of South Africa.

Learner pregnancies have increased in recent years, despite improved access to reproductive health services, contraceptives and sexual and reproductive education. In this article, a pregnant learner refers to any person who gets pregnant while being admitted as a learner in primary or secondary schools of the South African basic education system. Currently in South Africa there is no formal collaboration between the Departments of Health and Education concerning learner pregnancy prevention and management in schools. This study, conducted in Madibeng Municipality schools, aimed to develop implementation guidelines of the policy on prevention and management of learner pregnancy in schools. This qualitative, exploratory and descriptive study used a purposive sampling method. Data collection yielded 17 individual interviews and data was analysed using content analysis by Tesch's approach. Learners reflected that they lacked support from schools regarding learner pregnancy prevention and management, with the majority agreeing that nurses should visit schools to assist with reproductive health matters such as learner pregnancy. The education system of South Africa has invested in sexual and reproductive education, but learner pregnancies have doubled despite more than a decade of extensive sexual and reproductive education in schools. Stakeholders outside the classroom should be engaged to improve learner pregnancy prevention and management as part of support to teachers and schools. Such stakeholders include parents, peer educators, youth and community organisations, non-governmental organisations, community healthcare nurses and other relevant stakeholders.

Community health and public health nursing

Community health and public health nursing is a relevant issue in the context of the Portuguese National Health System reforms. International organizations, such as the World Health Organization, have emphasized the importance of nurses in community and public health care, and international studies report ongoing changes in this area in many countries. Through a Systematic Literature Review, conducted in early 2019, following an Equator Network protocol, Systematic Reviews, CRD's guidance for undertaking reviews in health care, prepared by York University, we addressed the research issue: what has been published about community health and public health nurse competencies and interventions. The inclusion of articles followed PRISMA 2009 and 36 of the total number of publications were selected. The contributions refer to the expansion of nurses’ competences, events such as health fairs, nutrition, and caries assessments, performance in contexts of natural disasters, development of management skills, understanding and influencing the making of public health policies. With the ongoing public health reform taking place in Portugal, it is also a good opportunity for nursing to investigate, produce, innovate, and recreate itself.

The better sleep better well-being programme: Educating and training community healthcare nurses in developing interventions for families of infants with moderate sleep problems: a pilot study.

The main aim of this pilot study was to evaluate the benefit of the Better Sleep Better Well-being (BSBW) educational and training intervention programme regarding infants sleep problems for Community Health Care (CHC) nurses, on their perceptions on their family nursing practice skills and on their job demand, control and support. There were 6 CHC nurses who participated in the BSBW programme, and 26 nurses in the comparison group. The programme consisted of 4 sessions (8hours per session) of lectures on the aetiology of infants sleep problems as well as on evidence-based and family relational practices and on 20 sessions of clinical cases, scenarios, discussions and reflections. The main finding indicated that the nurses in the intervention group reported significantly higher family nursing practices skills compared to the nurses in the comparison group. The findings are promising, since they offered additional resources to the CHC nurses, in their clinical practices.

Learning to learn differently

PurposeThis paper aims to investigate whether the formal and informal learning patterns of community health-care nurses changed in the wake of a reform that altered their work by introducing new patient groups, and to explore whether conditions in the new workplaces facilitated or impeded shifts in learning patterns.Design/methodology/approachData were collected through interviews with experienced nurses in community health care to learn whether and how they changed their learning patterns and the challenges they experienced in establishing new work practices.FindingsIn established learning patterns among nurses, the most experienced nurse passes on the knowledge to novices. These knowledge boundaries were challenged and they created new contexts and tasks calling for more cross-disciplinary cooperation. The informants acknowledged the need for formal and informal learning activities to change their learning pattern in addressing new knowledge challenges. Structural and cultural factors in community health care impeded changes in individual and collective learning patterns.Research limitations/implicationsThis paper reports a single case study. Further study is needed on how changes in structural and contextual conditions challenge the established formal and informal learning patterns.Practical implicationsIt is crucial that managers facilitate the development of new routines, structures and cultures to support individual initiatives and the growth of necessary changes in established practice to implement a new reform.Originality/valueThis study’s contribution to the literature primarily concerns how changes in structural conditions challenge formal and informal learning patterns, and the structural and cultural conditions for these learning patterns.

Acceptability Among Community Healthcare Nurses of Intelligent Wireless Sensor-system Technology for the Rapid Detection of Health Issues in Home-dwelling Older Adults.

Background:The effective care and support of community healthcare nurses (CHNs) contribute greatly to the healthy aging of older adults living at home. Integrating innovative technologies into CHNs’ daily practice offers new opportunities and perspectives for early detection of health issues and interventions among home-dwelling older adults.Aim:To explore the perception of acceptability among CHNs of an intelligent wireless sensor system (IWSS) for use in daily practice for the detection of health issues in home-dwelling older adults receiving home healthcare.Method:Descriptive and qualitative data were sourced from a pilot randomized controlled trial involving 17 CHNs using an IWSS in their daily practice to rapidly detect falls and other health issues in patients’ homes. IWSS alerts indicating behavior changes were sent to CHNs. Their perceived usefulness (PU) and perceived ease of use (PEOU) were assessed. The acceptability of IWSS technology was explored using a questionnaire and focus group discussions.Results:The PU and PEOU of the IWSS technology were low to moderate. A majority of the CHNs were dissatisfied with its performance and intrusiveness; they reported multiple obstacles in the usefulness and ease of use of the IWSS technology in daily practice.Conclusion:To improve the IWSS technology’s low to moderate acceptability among CHNs, we recommend a more user-centered implementation strategy and an embedded model of nursing care.

Izkušnje medicinskih sester v patronažnem varstvu z obiski na domu v okviru projekta Nadgrajena celovita obravnava pacienta: rezultati pilotne raziskave

Uvod: Patronažno zdravstveno varstvo je pomemben člen pri odkrivanju, spremljanju in obravnavi kroničnih bolezni na primarni ravni. Namen raziskave je bil predstaviti izkušnje in stališča do nadgrajene preventivne obravnave ter obiskov na domu.
 
 Metode: Uporabljen je bil mešani raziskovalni dizajn. Podatki so bili zbrani z delno strukturiranim vprašalnikom (Cronbach α = 0,92). Sodelovalo je 50 diplomiranih medicinskih sester, odzivnost je bila 81-% (n = 41). Opravljena je bila tematska analiza odprtih vprašanj. Za kvantitativne podatke je bila uporabljena opisna statistika, t-test, analiza variance in korelacijska analiza.
 
 Rezultati: Prispevek preventivnih obiskov na domu anketiranci vidijo v zdravstvenovzgojnem delovanju (x = 4,34, s = 0,85), odkrivanju rizičnih dejavnikov (x = 4,12, s = 0,81) in ohranjanju kakovosti življenja pacientov ( x= 4,10, s = 0,92). Zadovoljstvo anketirancev je povezano s sprejemanjem obiskov s strani pacientov in družin (r = 0,754, p < 0,001), s prispevkom k stroki patronažnega varstva (r = 0,766, p < 0,001) ter z obravnavo posameznika z družino (r = 0,693, p < 0,001). V tematski analizi sta bili identificirani dve temi, in sicer (1) pozitivne izkušnje z obiski in (2) negativne izkušnje z obiski.
 
 Diskusija in zaključek: Novo obliko preventivnih patronažnih obiskov v domačem okolju anketirani podpirajo, še posebej možnost celovite obravnave posameznika in njegove družine. Glede na ugotovitve se predlaga, da medicinska sestra v patronažnem varstvu postane enakovreden partner v timu referenčne ambulante na nacionalnem nivoju.

Understanding Insulin Pump Therapy

It is estimated that 375,000 Americans are utilizing insulin pump therapy to manage their diabetes. This article will educate community health care nurses regarding use of the insulin pump, and how to operate special settings for more effective glycemic control. Complications of pump therapy, as well as hyperglycemia, are not always avoidable; however, interventions are in place to prevent and treat complications. Furthermore, important assessment questions are employed to assist community health nurses in evaluating the patient knowledge base and management skills of their disease process in hyperglycemic episodes and emergency situations.

Shaping future delivery of care: district nurses seizing the day!

British Journal of Community NursingVol. 20, No. 6 Delivery of CareShaping future delivery of care: district nurses seizing the day!Caroline AW Dickson, Julie Bliss, Ben BowersCaroline AW DicksonSearch for more papers by this author, Julie BlissSearch for more papers by this author, Ben BowersSearch for more papers by this authorCaroline AW Dickson; Julie Bliss; Ben BowersPublished Online:4 Jun 2015https://doi.org/10.12968/bjcn.2015.20.6.266AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Ball J, Philippou J, Pike G, Sethi G (2014) Survey of District and Community Nurses in 2013: Report to the Royal College of Nursing. NNRU, London Google ScholarBoran S, Clarridge A (2005) Contemporary issues in district nursing. In: Sines DAppleby FFrost M. eds, Community Health Care Nursing. 3rd edn. Blackwell Publishing, Oxford:146–59 Google ScholarDepartment of Health Public health nursing (2013) Care in local communities - district nurse vision and model. bit.ly/1ILLbWy (accessed 20 May 2015) Google ScholarDepartment of Health, Social Services and Public Safety (2006) Modernising Nursing Careers: Setting the Direction. Department of Health, Social Services and Public Safety, Belfast Google ScholarISD Scotland (2014) NHSScotland Workforce Statistics. Nursing And Midwifery staff in post. bit.ly/1HvLzJa (accessed 20 May 2015) Google ScholarKelly A, Symonds A (2003) The Social Construction Of Community Nursing. Palgrave Macmillan, Basingstoke Crossref, Google ScholarKennedy C, Elliott L, Rush R, et al. (2009) Review of Nursing in the Community Baseline Study. www.gov.scot/resource/doc/269075/0079985.pdf (accessed 20 May 2015) Google ScholarNHS Education For Scotland (2012) Career & Development Framework for District Nursing. bit.ly/1Lp1A4Z (accessed 20 May 2015) Google ScholarNHS England (2014) Five Year Forward View. http://tinyurl.com/kcjenmc (accessed 20 May 2015) Google ScholarNHS Scotland (2007) Better Health, Better Care: An Action Plan. www.gov.scot/Resource/Doc/206458/0054871.pdf (accessed 20 May 2015) Google ScholarNHS Scotland (2013) A Route Map To The 2020 Vision For Health And Social Care. www.gov.scot/Resource/0042/00423188.pdf (accessed 20 May 2015) Google ScholarUnited Kingdom Central Council (2001) Standards for specialist education and practice. bit.ly/1KmcJpj (accessed 20 May 2015) Google ScholarWelsh Assembly Government (2009) A Community Nursing Strategy For Wales. Welsh Assembly Government, Cardiff Google Scholar FiguresReferencesRelatedDetailsCited byRCN backs the district nurse specialist practice qualificationJulie Bliss, Caroline Dickson1 August 2016 | British Journal of Community Nursing, Vol. 21, No. 8A patient's view on helping to shape a career framework for community nursesJulie Bliss, Iain Upton21 December 2015 | British Journal of Community Nursing, Vol. 21, No. 1 2 June 2015Volume 20Issue 6ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 4 June 2015 Published in print 2 June 2015 Information© MA Healthcare LimitedPDF download

New kid on the block? Community nurses' experiences of caring for sick children at home.

To investigate the experiences of Swedish community nurses in caring for sick children at home, as this is a growing population of patients in community care. There is international consensus that sick children should receive care in their homes as far as possible. Home health care allows the family to stay together while the child is undergoing treatment and thus reduces strain on the family. However, it can also be demanding for parents to take on increased responsibilities for their sick child. Children as a patient group is a relatively new phenomenon in community home health care in Sweden and represents a small part of the community nurse responsibilities, making it difficult to accumulate experience. A qualitative descriptive design. In-depth interviews with twelve nurses in community health care. Qualitative content analysis was used. 'Feeling confident in order to instil confidence' was key in nurses' experiences. Two main themes emerged: 'Building a trusting relationship with the family' and 'Feeling confident in the role as caregiver'. Nurses aimed at creating a trusting nursing relationship and working closely with parents. The nurses' feeling of confidence in their role as caregivers depended on the support they received and the knowledge they had. Many community nurses felt unconfident about caring for children at home but experienced it as manageable when peer support and a distinct collaboration with the paediatric clinic/hospital were present. The ongoing shift from hospital to home care urges paediatric clinics/hospitals and community health care to develop formal policies of transmural collaboration to train and support home nurses to deliver adequate care to sick children and their families at home and safeguard good outcomes. The implication of the study may contribute to efforts being made to extend and improve cooperation between paediatric clinics/hospitals and community health care.

Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services

The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

Effect of home care nursing on elderly hypertensive patients in community

Objective To explore the effect of home care nursing on elderly hypertensive patients in community services .Methods Totals of 76 cases of elderly hypertensive patients were randomly divided into the experimental group and the control group , with 38 patients each .Six-month of home care nursing was adopted in the experimental group , and conventional community nursing was adopted in the control group .The therapeutic effect was compared between the two groups .Results After the intervention ,the systolic pressures and diastolic pressures of patients in the experimental group were （123.13 ±4.01）, （82.75 ±4.56） mmHg, respectively, which were significantly lower than the systolic pressures （ 146.00 ±6.32 ） mmHg and diastolic pressures （90.71 ±6.72）mmHg of patients in the control group （t =10.627, 3.332, respectively; P 〈0.05）.The medication compliance in the experimental group was increased from 21 patients to 36 patients, while there was no change in the control group.The difference was significant （χ2 =10.287, P〈0.05）.Conclusions Home care nursing model can reduce blood pressure more effectively and enhance the treatment effect .It is worthy of popularizing among the elderly hypertensive patients . Key words: Community health care nursing; Elderly patients; Hypertension; Home care

Advanced physical assessment skills: implementation of a module

This article aims to explore and examine advanced physical assessment skills and the role of the district nurse. It will particularly highlight district nurses' perceptions of how they may implement skills learnt on a new module introduced into the Community Health Care Nursing degree at a university in London. Physical assessment skills have traditionally been viewed as part of a doctor's role; however, with the advancement of nursing roles, it is argued that it has become a key nursing skill. As Government policy continues to expect health professionals to keep patients in the community who have complex health and social care needs, the role of the district nurse presents as 'best placed' to take on this challenge (Department of Health (DH), 2005a; 2005b). Evaluation of the district nurses' perceptions of their practice is shared here, highlighting some of the challenges that they face. The article will address the complexity of developing a curriculum in response to the DH initiatives and the importance of listening to students on courses.

Quality of Life Model: Predictors of Quality of Life Among Sick Older Adults

The aim of this study was to explore how depressive symptoms, physical function, health satisfaction, age, and environmental conditions predict quality of life (QoL) in a conceptual model based on the Wilson and Cleary's Model (WCM). A stratified sample by age, gender, and living area was drawn from the Norwegian population of older adults receiving community health care (mean age of 78.6 years, 94.4% living at home, 5.6% living in nursing homes). The study is part of a larger international study. Face-to-face interviews were conducted using the WHOQoL-Old, the WHOQoL-Bref Environment domain, the Geriatric Depression Scale, the Short Form SF-12, and sociodemographic and health questions. A path analysis (structural equation modeling) showed that the overall model provided empirical evidence for linkages in the WCM. QoL was manifested by significant direct effects of environmental conditions and health satisfaction. In addition, environmental conditions had indirect effects on QoL, in particular via depressive symptoms and health satisfaction. This model may help nurses in community health care to collect and assess information, to suggest suitable interventions, and to guide decision making.

Registered Nurses working together with family members of older people

The aim of the study was to reach a more profound understanding, through looking at nurses' working situation, of those factors that influence how nurses are able to work together with family members of older people living in nursing homes or similar facilities. Working with the care of older people as a Registered Nurse provides a varied job with many challenges. Nurses have to co-operate with family members of those in community health care. Co-operation is important and necessary for all involved. Nurses working in elder care in a geographically defined area received a questionnaire with three open-ended questions, on the difficulties and/or problems involved with working together with family members, and the positive or negative aspects of this co-operation. Analysis was carried out using the latent content analysis method. Three themes, problems within the system, interaction with families and caring in nursing work, are presented with categories and their subcategories. The nurses wanted their superior to be a nurse so that their working situation would be better understood. Appreciation from their superior and family members was also a very important part of their work as nurses in community health care. The frequent changes and the lack of time in the work of elder care often put nurses under considerable psychological pressure. For the most part family members are a resource for the elder, but sometimes they will avoid contact, which will make co-operating difficult. Registered Nurses and family members are dependent on each other in their care of the elder. Relevance to clinical practice. More attention should be paid to the working situation of Registered Nurses in community health care, and their ability to work together with family members of older people.

Community Healthcare Nursing: frameworks for practiceCommunity Healthcare Nursing: frameworks for practice

One of the fastest changing areas of nursing is the context in which community nurses work, and therefore the role of community nurses. The second edition of this useful text provides an overview of the main forces behind community nursing and a rationale for necessary developments in its practice.

Observations of nurses' treatment of leg and foot ulcers in community health care.

The aim of the study was to obtain knowledge about leg and foot ulcer care performed by nurses in community health care. This is a descriptive observational study. SETTINGAND SUBJECTS: The sample consisted of Norwegian home care nurses (n = 31), student nurses (n = 30), and patients with leg and foot ulcers (n = 32). Thirty-five ulcer treatments were observed in the patients' homes. A structured observation form with space for additional notes and assessments was used. Photographs were taken of the ulcers. Information on background variables for patients and nurses was collected, and descriptive and interpretive analyses were performed. Nursing students made the observations. In 16 situations the patients had no ulcer diagnosis, and most of the patients (79.9%) had other serious chronic diseases. The home care nurses were uncertain about their assessment of the ulcers, and the treatment principles were not always current; for example, dry dressings and normal saline were used for cleansing. Twenty-eight different dressing combinations were used on the 35 ulcers. Compression was used on undiagnosed ulcers, sometimes incorrectly. Hand-washing routines were poor, and the treatment was often poorly documented. Poor working conditions were also observed, such as bad lighting in the room. The majority of the ulcer treatments lasted 20 to 30 minutes. The study identifies areas where leg and foot ulcer treatment by home care nurses can be improved with respect to technique and documentation.

Observations of nurses' treatment of leg and foot ulcers in community health care

Objective The aim of the study was to obtain knowledge about leg and foot ulcer care performed by nurses in community health care. Design This is a descriptive observational study. Setting and subjects The sample consisted of Norwegian home care nurses (n = 31), student nurses (n = 30), and patients with leg and foot ulcers (n = 32). Thirty-five ulcer treatments were observed in the patients' homes. Methods A structured observation form with space for additional notes and assessments was used. Photographs were taken of the ulcers. Information on background variables for patients and nurses was collected, and descriptive and interpretive analyses were performed. Nursing students made the observations. Results In 16 situations the patients had no ulcer diagnosis, and most of the patients (79.9%) had other serious chronic diseases. The home care nurses were uncertain about their assessment of the ulcers, and the treatment principles were not always current; for example, dry dressings and normal saline were used for cleansing. Twenty-eight different dressing combinations were used on the 35 ulcers. Compression was used on undiagnosed ulcers, sometimes incorrectly. Hand-washing routines were poor, and the treatment was often poorly documented. Poor working conditions were also observed, such as bad lighting in the room. The majority of the ulcer treatments lasted 20 to 30 minutes. Conclusion The study identifies areas where leg and foot ulcer treatment by home care nurses can be improved with respect to technique and documentation.

Observations of Nursesʼ Treatment of Leg and Foot Ulcers in Community Health Care

In Brief Objective The aim of the study was to obtain knowledge about leg and foot ulcer care performed by nurses in community health care. Design This is a descriptive observational study. Setting and subjects The sample consisted of Norwegian home care nurses (n = 31), student nurses (n = 30), and patients with leg and foot ulcers (n = 32). Thirty-five ulcer treatments were observed in the patients' homes. Methods A structured observation form with space for additional notes and assessments was used. Photographs were taken of the ulcers. Information on background variables for patients and nurses was collected, and descriptive and interpretive analyses were performed. Nursing students made the observations. Results In 16 situations the patients had no ulcer diagnosis, and most of the patients (79.9%) had other serious chronic diseases. The home care nurses were uncertain about their assessment of the ulcers, and the treatment principles were not always current; for example, dry dressings and normal saline were used for cleansing. Twenty-eight different dressing combinations were used on the 35 ulcers. Compression was used on undiagnosed ulcers, sometimes incorrectly. Hand-washing routines were poor, and the treatment was often poorly documented. Poor working conditions were also observed, such as bad lighting in the room. The majority of the ulcer treatments lasted 20 to 30 minutes. Conclusion The study identifies areas where leg and foot ulcer treatment by home care nurses can be improved with respect to technique and documentation. In a sample consisting of thirty-one home care nurses in Norway, it was found that they were uncertain about their assessment of leg and foot ulcers, and that their principles of treatment were not always current.