Developing Community Nursing Practice: Promoting Case Management and Skill Enhancement to Support Shifting the Balance of Care

Abstract

Five inter-related projects were commissioned by NHS Highland to further knowledge and understanding of key issues that can be used to inform particular aspects of care delivery that supports the community nurse review. The five projects reflect some of the core elements that have been identified to maximise nurses’ contributions in community settings (Scottish Executive 2006a). The projects were designed to provide qualitative evidence of the views of community nurses regarding case management and to support the delivery of skills in community nursing practice. Additionally community nurses identified the knowledge and skills required to develop practice tools that would support areas of generalist and specialist practice, specifically around child welfare and long term conditions (heart care). The five projects were: i. Literature review on case management models in Community Nursing. ii. Action research project to support implementation of Case Management Models in community nursing. iii. Literature review on practitioners with special interest. iv. Research to inform development of practitioner tools for child protection and long term conditions (heart care). v. Research to explore skills transition to support Shifting the Balance of Care. This project focused on 3 key initiatives that are influencing community nursing and it was apparent that they all shared common goals and challenges of implementation. For this reason, it was clear that any development in service provision would impact on, and articulate with, other health, social and profession based changes and could not be implemented in isolation from other related developments that underpin shifting the balance of care. Nurses in the studies articulated insightful challenges for shifting the balance of care, and related role developments, but these were, in the majority, followed by offering practical solutions.