Reshaping Public Health Nursing in the Republic of Ireland

Across the world, there are concerns about how nursing and midwifery services are delivered in community settings. In the Republic of Ireland (ROI), significant economic contraction since 2009 has resulted in a decrease in the number of personnel available at a time when the older and younger population has been increasing. The purpose of this article is to outline a change initiative made in one public health nursing service in the ROI. In this change process, public health nursing staff moved from generalist to specialist roles. Distinct teams were created to deal with clinical care and child health, welfare, and protection. A key feature of the clinical team was the utilisation of a corporate caseload approach. The change was prompted by a reduction in staffing numbers, vacant caseloads, and increasing clinical risks and activity. Initial response to the change from frontline staff, management, and patients has been positive. The main effects of the change were noted in caseload management, risk management, and increased focus on clinical supervision. An external evaluation of the change initiative was carried out in 2014.