Making the complexity of community nursing visible: the Cassandra project

Area of Science:

• Nursing Workforce Research
• Health Services Management
• Community Health

Background:

• Promoting safe staffing in community settings requires robust workforce evidence.
• Current methods for measuring community nursing workload in England face challenges.
• Effective service design and future skill mix depend on systematic workforce data.

Purpose of the Study:

• To review current approaches and challenges in measuring community nursing workload activity in England.
• To present pilot results of the Cassandra Matrix activity tool for community nursing.
• To assess the scalability of the tool for national implementation.

Main Methods:

• A mixed-methods pilot study collected 10 days of workload activity data from band 5-7 nurses in three community organizations.
• Data collection involved the Cassandra Matrix activity tool and an electronic survey evaluating user experience.
• The study focused on general and specialist community nursing roles.

Main Results:

• The Cassandra Matrix tool demonstrates significant potential for capturing the complexity of community nursing work.
• Pilot findings suggest the tool can effectively measure multiple dimensions of nursing activity.
• Phase 2 is piloting a community-specific version of the tool across six organizations.

Conclusions:

• The Cassandra Matrix tool is a promising method for assessing community nursing workload.
• The tool's ability to capture work complexity supports evidence-based decisions on staffing and skill mix.
• Further large-scale piloting indicates scalability for national adoption in community nursing.