Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/10437
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dc.contributor.authorKyle, Richard Gen_UK
dc.contributor.authorBanks, Micheleen_UK
dc.contributor.authorKirk, Susanen_UK
dc.contributor.authorPowell, Peteren_UK
dc.contributor.authorCallery, Peteren_UK
dc.date.accessioned2014-09-13T13:27:52Z-
dc.date.available2014-09-13T13:27:52Z-
dc.date.issued2012-07en_UK
dc.identifier.urihttp://hdl.handle.net/1893/10437-
dc.description.abstractBackground: Despite the policy principle that "children are best cared for at home whenever possible" children continue to have high rates of emergency department (ED) attendance and emergency hospital admission. Community Children's Nursing Teams (CCNTs) can care for acutely ill children at home but their potential to provide an alternative to ED attendance and hospitalisation depends on effective integration with other services in the urgent care system, such as EDs and Observation and Assessment Units (OAUs). Although challenges of integrating CCNTs have been identified, there has been no comparative assessment of the factors that facilitate or hinder integration of care of acutely ill children by CCNTs with the urgent care system. The aim of this study was to identify enablers and barriers to integration of CCNTs with urgent and emergency care. Methods: Comparative case studies were conducted of two CCNTs serving Primary Care Trusts in North West England. Twenty-two health professionals including CCNT managers and staff; paediatricians; nurses; children's ward, ED and OAU staff; commissioners of children's services; GPs and primary care staff were interviewed between June 2009 and February 2010. Qualitative data were analysed thematically using the Framework approach. Results: Barriers to integration included paediatricians' perceived lack of ownership of the CCNT, poor communication between consultants and community children's nurses (CCNs), and weak personal relationships. This prevented early referral to the CCNT as an alternative to hospital care. Enablers of integration included co-location and rotation of CCNs through urgent care settings including OAUs and EDs. This enabled nurses to develop skills, make decisions about referral to home care and gain the confidence of referring clinicians. Conclusions: Integration of CCNTs at multiple points in the urgent care system is required in order to provide an alternative to inappropriate ED attendances and emergency admission. The principal enablers and barriers are both aspects of normative integration, which involves shared understanding of the contribution of CCNTs and trusting relationships between practitioners. Co-location and rotation of CCNs through acute services can promote integration and appropriate referrals to CCNTs to support families to care for children at home.en_UK
dc.language.isoenen_UK
dc.publisherBioMed Central Ltden_UK
dc.relationKyle RG, Banks M, Kirk S, Powell P & Callery P (2012) Integrating community children's nursing in urgent and emergency care: a qualitative comparison of two teams in North West England. BMC Pediatrics, 12 (101). https://doi.org/10.1186/1471-2431-12-101en_UK
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Published in BMC Pediatrics, 12 (101), The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2431/12/101en_UK
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/en_UK
dc.titleIntegrating community children's nursing in urgent and emergency care: a qualitative comparison of two teams in North West Englanden_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1186/1471-2431-12-101en_UK
dc.citation.jtitleBMC Pediatricsen_UK
dc.citation.issn1471-2431en_UK
dc.citation.volume12en_UK
dc.citation.issue101en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.author.emailrichard.kyle@stir.ac.uken_UK
dc.contributor.affiliationHealth Sciences Health - Highland - LEGACYen_UK
dc.contributor.affiliationUniversity of Manchesteren_UK
dc.contributor.affiliationUniversity of Manchesteren_UK
dc.contributor.affiliationWest Suffolk Hospital NHS Trusten_UK
dc.contributor.affiliationUniversity of Manchesteren_UK
dc.identifier.isiWOS:000311645600001en_UK
dc.identifier.scopusid2-s2.0-84865999222en_UK
dc.identifier.wtid757411en_UK
dc.date.accepted2012-07-16en_UK
dc.date.filedepositdate2013-01-08en_UK
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

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