Analysis

Queen’s Nursing Institute champions specialist qualification for district nurses

At the end of last year, a Queen’s Nursing Institute report stated that district nurses (DNs) who complete a specialist practitioner qualification are best placed to manage complex caseloads and make decisions about patients’ needs.

At the end of last year, a Queen’s Nursing Institute report stated that district nurses (DNs) who complete a specialist practitioner qualification are best placed to manage complex caseloads and make decisions about patients’ needs.


Queen’s nurse Candice Pellett

The report, written by Queen’s nurse Candice Pellett, promotes the value of the specialist practitioner qualification in district nursing (SPQDN) and is based on focus groups with Queen’s nurses, nursing educators and students, an online survey, a literature review and data analysis.

Of the 407 survey respondents, 62% felt that if a nurse did not have a qualification, aspects of patient care could be compromised and poor decisions might be made regarding patients’ needs.

Judgement

Nearly nine-tenths said they had higher levels of judgement and decision-making skills after completing the qualification.

The course helps community nurses provide holistic care, manage complex caseloads, prevent unnecessary hospital admissions and promote patient safety.

Ms Pellett, who is also a practice teacher, says there is ‘a distinct lack of published research’ on the value of the specialist practitioner qualification in district nursing.

More complex

‘DNs’ caseloads are much more complex than they were five years ago,’ she says. ‘Community is becoming a busy place to work with complex care needs and people living longer. It is paramount we have leaders of the future who can deliver the care required and lead teams.’

She says there are various barriers to district nurses obtaining the qualification, including that they may receive a lower salary when studying and have difficulty being released for the training because of staff shortages.

While the majority of respondents said that their organisation seconds nurses to take the course, 15.6% said that they were prevented from taking it because employers only supported a modular approach.

The QNI has been campaigning for renewed investment in the SPQDN in a bid to reverse the decline in the number of courses offered and the number of new DNs taking the course.

Benefits for employers

‘There is greater recognition that this qualification not only benefits families and carers but employers and organisations as well. But there’s still work to do.’

She would like to see the course offered more widely, adding: ‘Not every community nurse wants to undertake the qualification but there should be more opportunities for people to do it if they want to.’

‘The course creates confident and safe practitioners and gives assessment skills, particularly in prescribing,’ she explains.

In a report published last year, the RCN expressed concerns about the depletion of district nursing posts, particularly those with specialist skills. It stated that between May 2010 and December 2014, there was a 28% reduction in the number of specialist DNs, a loss of 2,168 posts across England. In 2014, the RCN issued a warning that DNs could face extinction by the end of 2025 if urgent investment is not made.

It cited a 47% reduction in qualified DNs in England in the decade preceding 2014.

Workforce gap

Alison Leary, chair of healthcare delivery and workforce modelling at London South Bank University (LSBU), says: ‘This is a big drop, especially when we need to move care into the community and there are more people living longer with comorbidities.’

In an ongoing study commissioned in 2014, Health Education England for Kent Surrey and Sussex have set LSBU and Canterbury Christ Church University the task of looking at optimum caseloads for DNs to support better workforce planning.

But Professor Leary says: ‘Caseloads are not comparable to workload because they are dependent on so many different factors – GP provision, pharmacy, the multidisciplinary team the nurse is working with and the complexity of the case.’

Interventions

‘The range of interventions that district or community nurses provide is extremely diverse and the knowledge they require is vast. They have a huge amount of knowledge but also have skills in brokering and how to manage care.’

She says there should be more undergraduate and transition programmes, as well as courses such as the SPQDN that provide a recognised qualification and help graduates work in the community much earlier on in their careers.

‘In order to fill the workforce gap, we need graduate nurses to go straight into the community. We need to offer a structured development programme that leads to them doing this qualification and then going beyond it.’

Jennifer Sprinks is assistant editor, RCNi

 

 

 

 

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