The Delineation of Advanced-Level Practice Within UK District Nursing: A Cross-Sectional Comparative Study Before and...

Advanced practice nursing is key in response to increasing healthcare demands and the need for Universal Health Coverage. District nursing, which involves care for people in their own homes, has undergone a significant transformation to manage complex long-term conditions and reduce hospital admissions.

This study aims to identify the advanced practice domains of UK district nurse team leaders, before and after policy reforms designed to prevent unnecessary admission to hospital. A secondary aim is to compare the advanced practice domains of district nurse team leaders with those of advanced practice nurses working in family and community nursing.

A cross-sectional study was conducted. Data were collected via an online survey using the Family and Community Nursing Advanced Practice Scale, assessing five key domains of advanced practice. The study employed ANOVA and t-tests to compare groups.

A total of 448 district nurse team leaders participated in this study, and secondary data from 548 family and community nurses were retrieved. No significant differences were found across qualification groups for most advanced practice domains, except for medication prescribing. Comparisons with advanced practice nurses in family and community settings revealed significantly higher scores in all domains and similar scores in leadership competencies.

Experiential learning plays a crucial role in developing advanced practice competencies beyond formal qualifications. The results align with Kolb's theory, highlighting the importance of clinical exposure and mentorship in shaping advanced nursing skills.

District nurse team leaders exhibit key advanced practice competencies. Credentialing frameworks may help formally recognise the expertise developed through clinical experience.

Policymakers should consider enhancing experiential learning opportunities and credentialing systems to support district nurses in their transition to advanced practice.