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Using a complex audit tool to measure workload, staffing and quality in district nursing
1Deputy Director of Nursing, Quality and Patient Experience, Cumbria Partnership NHS Foundation Trust.
British Journal of Community Nursing
|May 3, 2014
Summary
This study found that heavy workloads and patient acuity in community settings strain staffing, impacting care quality and increasing costs. Shortages also force staff to travel extensively for complex patient needs.
Area of Science:
- Community health nursing
- Healthcare workforce studies
- Quality improvement in healthcare
Background:
- Comprehensive community staffing project in England involving over 400 staff across 46 teams in 6 localities.
- Benchmarking against Scotland using the evidence-based Safer Nursing Care Tool methodology.
Purpose of the Study:
- To comprehensively analyze community staffing, workload, and quality.
- To link community staffing activities directly to workload and patient care quality.
Main Methods:
- Data collection assessed quality standards, patient acuity, dependency, and nursing interventions.
- Examined caseloads, staff activity, service quality, and various staffing levels (funded, actual, temporary, recommended).
Main Results:
- Four out of six localities experienced heavy workload indices, stretching staffing and patient interaction time.
- Patient acuity and dependency were high, requiring more intensive care.
- High use of temporary staff negatively impacted quality and increased expenses.
- Skill and competency shortages necessitated significant travel for staff delivering complex care.
Conclusions:
- Community healthcare settings face significant challenges with workload, staffing levels, and patient acuity.
- The findings highlight the need for optimized staffing models and skill development to ensure quality care delivery and cost-effectiveness.
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