Questions we should ask about community nursing practice

Abstract

This paper identifies some of the key questions that researchers should address in relation to community nursing practice in the UK. The paper begins with a brief overview of the nature and impact of change within the UK health service and the way this has impacted on community nursing. It argues that the nature and scale of such change means that it is important to investigate any resultant threats to the safety of patients and clients, to the quality of their care and to the capacity of the service to meet health care needs. However given the difficulties associated with identifying links between the quality of care and policy driven change, the author argues that a more appropriate approach would be to focus on investigating the effectiveness of practice and seeking explanations for variation in practice. The paper makes reference to the complex knowledge base used in community nursing practice and acknowledges the challenges for nurses in internalising messages from the social science disciplines in order to strive to achieve effective practice. Drawing on some current research studies the author then highlights the importance of developing a better understanding of the interpersonal skills used in practice. The author then moves on to consider wider issues of practice including delegation, supervision and teamwork, arguing that insufficient attention has been paid to effectiveness in these domains. In concluding, the author makes the case that questions should be pursued in all these areas with a focus on exploring variation in practice so that a broader more theoretically based understanding of what is effective in practice can be achieved.