Assessment for long-term care: a snapshot of nursing practice

A study was carried out to examine nurses' assessments of clients to provide a basis for long-term placement decision-making, in both the community and hospital settings. The recommendations made by nurses, based on their assessments, have huge implications for clients. The study was carried out in south-east London. A semi-structured questionnaire was used to gather information on aspects of the assessment process, and a vignette was used to ascertain how nurses assess their clients for long-term care. The questionnaires were sent to 45 district nurses and elderly care nurses involved in assessing clients for long-term care. There was wide variation in nurses' assessments and opinions on the appropriate timing of the assessments. Nurses did not identify the importance of allowing individuals the opportunity to rehabilitate and recuperate before the nursing assessment and so made potentially inappropriate recommendations. The nurses highlighted that they were given little formal training on how to complete assessments and had limited knowledge about the different care options available for their clients. Nurses had differing opinions on who should carry out particular care tasks--registered nurse or carer. This has implications for the determination of whether a client is entitled to, and the level of, free nursing care. The variations in nurses' assessments indicated the importance of having more formal structures in place to train and support nurses undertaking this potentially life-changing work.