Matron Role Research Articles

Community matrons: Inter-professional and inter-agency working (part five)

This is the penultimate article developed from a series of masterclasses organised and funded by the Department of Health for community matrons during summer 2006. The articles synthesise the masterclass content in order to describe the areas of practice that are common to the community matron role and which have to be practiced with high levels of knowledge and skill if community matrons are to deliver the expected benefits to patients and to the NHS. It uses a case study to explore the fundamental concepts of accountability, teamwork; knowing the system; assertiveness; advocacy and empowerment which community matrons identified consistently as being significant in ensuring successful interprofessional and inter-agency working.

An evaluation of a community matron service from the patients’ perspective

Community matrons are a relatively new government initiative aimed at case managing people with long-term conditions to reduce the number of emergency bed days used in hospitals. Although there have been extensive evaluations of similar case management projects, to date there has been little evaluation of the community matron's role and the perceptions patients have of this new service. One of the main Government agendas for care is to deliver a high quality service driven by the needs of the service users (DH, 2000). In order to drive this agenda, care is to deliver a high quality service driven by the needs of the service users (DH, 2000). In order to drive this agenda, it is important that the views and perceptions of people on the receiving end of the services are heard, valued and appropriate actions taken. This two part evaluative report sets out to explore how people with long-term conditions perceive the impact of community matrons and the differences this new service may have had on their lives. Questionnaires were sent to 100 patients who were currently being case-managed by a community matron to evaluate the community matron service from the patients' perspective. Part two reports on patients' perceptions of the community matron role and the influences of the role on their health.

Community matrons: advanced assessment skills (part three)

This is the third of six articles which draw on the content of a series of masterclasses organised and funded by the Department of Health for community matrons during summer 2006. The articles synthesise the content presented during these masterclasses in order to describe the areas of practice that are common to the community matron role and which have to be practised with high levels of knowledge and skill if community matrons are to deliver the expected benefits to patients and to the NHS. It draws on input to the community matrons masters classes from Andrew Havers, Cath Molineaux, Nancy Williams and Duncan Petty.

Achieving the best outcome.

The community matron role is one of the new roles in which nurses are responding to the radical reform of the NHS workforce. As advanced clinical nurses, they have had to develop their knowledge and learn new skills in order to set up the new service of co-ordinating the care of those with highly complex long term conditions.

Caring for patients with COPD and their families in the community

Community matrons have a key role to play in the management of patients with long-term conditions. With the expected increase in prevalence of Chronic Obstructive Pulmonary Disease (COPD), largely due to cigarette smoking, the management and care of patients with COPD is a priority for the NHS. This paper examines the current and future role of community matrons in the management of patients with COPD. Community matrons have a potential role in providing evidence based care and could fill a gap in the implementation of effective interventions to help patients and family members stop smoking. A family focused approach to assessment and case management are important to achieving quality care and management of these patients. Recommendations are made with respect to the improvement of service provision for individuals and families with COPD.

Education and support needs for the community matron role

Education and support needs for the community matron role

Patient and carer perceptions of case management for long-term conditions

Nurse-led case management programmes have become increasingly popular over the last 15 years. Countries such as the USA, Canada, Sweden and the Netherlands have long running case management programmes in place for frail elderly people. The Department of Health in England has recently introduced a 'community matron' role to provide case management to patients with highly complex long-term conditions; a group that is predominantly comprised of elderly people. Department of Health policy documents do not define the day-to-day role of community matrons but instead describe the objectives and principles of case management for long-term conditions. The aim of this qualitative study was to describe case management from the perspective of patients and carers in order to develop a clearer understanding of how the model is being delivered for patients with long-term conditions. In-depth interviews were conducted with a purposive sample of 72 patients and 52 carers who had experience of case management. Five categories of case management tasks emerged from the data: clinical care, co-ordination of care, education, advocacy and psychosocial support. Psychosocial support was emphasised by both patients and carers, and was viewed as equally important to clinical care. Patient and carer perceptions of case management appear to contrast with descriptions contained in Department of Health guidance, suggesting an 'implementation surplus' in relation to the policy. This particularly appears to be the case for psychosocial support activities, which are not described in official policy documents. The provision of significant psychosocial support by community matrons also appears to differentiate the model from most other case management programmes for frail elderly people described in the literature. The findings emphasise the importance of seeking patient and carer input when designing new case management programmes.

Auditing the impact of implementing the Modern Matron role in an acute teaching trust

This paper describes how an acute teaching trust established the role of Senior Nurses (Modern Matrons) and an audit that was undertaken 12 months after they were appointed to evaluate the role. The concept of the Modern Matron was introduced in 2000 and all trusts had to implement the role by April 2002. The audit comprised: measurement of progress against agreed corporate objectives and questionnaires to all senior nurses and a range of trust staff staff. The following themes were identified: Senior Nurse post, patient care, infection control and leadership. Senior nurses were found to be satisfied with their role and the preparation for and understanding of their role seemed to be successful. There were many improvements such as a reduction in drug errors, complaints and MRSA bacteriaemias. Implementation of the Modern Matron role has been successful and made improvements in patient care.

Developing the community matron role in care homes

Care homes in England deliver complex packages of care to people with long-term conditions. The current policy focus on improving care pathways, choice and self-determination for people with long-term conditions offers tremendous opportunities for partnership working between the private and the public sector. This article describes an initiative to introduce the role of the community matron into the care home setting.

Developing the role of the community matron: the cornwall experience

Community matrons have made a big impact in cornwall, as helen lyndon explains

District nursing is complex, dynamic and proactive

With regard to recent articles about the demise of the traditional district nursing role and the evolving community matron role (features March 29, news April 5), I feel the need to question the content of these articles.

Evaluation shows matron role is appreciated by patients and staff

Evaluation shows matron role is appreciated by patients and staff

Community matron implementation: meeting the challenge in Leeds

The introduction of the community matron role is an important milestone in the national strategy for the management of long-term conditions (DH, 2005a). Community matrons are seen as key in delivering personalized, managed care to adults with complex long-term needs. The Department of Health requires there to be 3000 community matrons in posts across England by March 2007 (Beasley et al, 2005). Leeds North West PCT is required to have seven community matrons in 2005/2006 and 13 by March 2007. This article describes the process of the introduction of the first wave of community matrons in North West Leeds.

The role of community matrons in supporting patients with long-term conditions

The role of community matrons in supporting patients with long-term conditions

The role of community matrons in supporting patients with long-term conditions

The new emphasis on patients with long-term conditions offers a vision of a primary health care service that will reduce the need for hospital admission. This article debates the implications of introducing the new advanced nursing role of community matron for patients with long-term conditions and the opportunities this may offer nursing.

Outcomes of modern matron implementation: Trust nursing directors’ perceptions and case study findings

Summary Objectives To examine one aspect of a larger study evaluating the modern matron role, comparing trust nursing directors’ perceived outcomes of introducing matrons to the NHS with actual evidence of such outcomes gathered in ten subsequent case studies. Design, methods and outcomes In a national survey, nursing directors stated their perceived outcomes arising from introduction of matrons; these outcomes were compared with case study findings. Participants and settings: Survey Questionnaire to Directors of Nursing in all 545 NHS trusts in England in 2003. Case Studies Ten NHS trusts purposively selected to include different types in varied settings. Data collection involved interviews and questionnaires to matrons, other relevant staff and some patients, and use of routinely collected data. Results Sixty percent of 414 survey respondents reported positive outcomes such as improvements in staff management, leadership, patient environment and standards of care, whereas only 36% reported negative outcomes such as role ambiguity and role overload for matrons. Most of the reported positive outcomes were recognised in subsequent case studies. Conclusions Positive outcomes attributed by directors of nursing to matron appointments appeared to outweigh negative outcomes. There was evidence of these positive outcomes in subsequent case studies.

Sue Burke: a community matron with passsion

The community matron role was made for Sue Burke. Having been a staff nurse in Basildon PCT for 10 years, she started her district nurse training in 2003. While training, she started to notice that many of her nursing home clients were not being assessed, ‘purely because they had no obvious nursing need.’ Her subsequent career path has grown out of this observation.

Community matrons' rounds: the unbroken thread

The article on the return of ‘matrons’ rounds' (Castledine and Close, 2005) describes a triple role for the new matrons. It is an exemplar role in relation to standards of care (demonstrating hand-washing and auditing cleanliness), a supervisory role (regarding nurses' progress and workload), as well as a public relations role for the benefit of patients and relatives (finding out their perceptions of care, ‘being visible’ and educating them). This is an interesting contrast to the new role of community matron, which is a clinical (care giving) and case-management role evolving directly from the existing district nurses' rounds.

The management of patients with long-term conditions

This article provides an overview of chronic disease management for patients. Background from the approach used in the United States is provided along with UK developments, and there is discussion about the role of the nurse in patient empowerment and the role of the community matron in case management.

The management of patients with long-term conditions

This article provides an overview of chronic disease management for patients. Background from the approach used in the United States is provided along with UK developments, and there is discussion about the role of the nurse in patient empowerment and the role of the community matron in case management.