Beruflich Dokumente
Kultur Dokumente
ON
NURSING IN THE COMMUNITY
Presenters:
Collis Rochester-Peart
Service Manager / Clinical Lead (Haemoglobinpathies)
Lambeth Primary Care Trust
and
Dr. Lorna Bennett
Clinical Services Manager (Haemoglobinpathies)
Islington Primary Care Trust
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Nursing In The Community
Collis Rochester-Peart
Service Manager / Clinical Lead
(Haemoglobinpathies)
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
Nursing In The Community
Introduction
• Objectives
• Context
• Models of community nursing care in the
haemoglobinopathies
• Description of local models of community
nursing
• Benefits of case management
• Challenges of case management
• Summary
• Reference list
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
Nursing In The Community
Objectives
• The case for care in the community has been steadily made:
◦ Thomas and Westerdale (1996) discussed the problems
arose from inadequate and poorly functioning community care and
suggested immeasurable benefits can accrue from developing sickle
services similar to other acute on chronic diseases;
◦ Smith-Wynter and van den Akker (1999) feasibility study showed it was
possible to manage non-complicated crises within the home with
increased input from primary care, especially community and specialist
haemoglobinopathy nurses
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
Nursing In The Community
Context (3)
• Governmental Directives - Lord Darzi’s new foundation
for health service - The NHS Next Stage Review
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
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The Community
Community
Local Model (2)
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
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NursingAInThe
The Community
Community
Local Model (3)
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
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NursingInInThe
TheCommunity
Community
A Local Model (4)
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
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Benefits of the model
Stakeholders’ Benefits
• Clients:-
Individualised care plans
◦ Care co-ordination from a named professional
◦ Increased time and attention from names professional
◦ Named professional with increased/full knowledge of case
◦ Shortened care pathway
◦ Closer work with young people
• Nurses:-
◦ More defined case-load
◦ Increased specialist knowledge
◦ Increased autonomy of care
◦ Delivering more focused care.
◦ Delivering nurse-led clinical intervention
• Organisation (PCT):-
◦ Increase targeting of complex clients
◦ Value for money service (Evaluation pending)
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
Nursing In The Community
• Challenges / Barriers
◦ Drivers for change agenda
◦ Maintaining continuity of care
◦ Maintaining patient focused care
◦ Sharing of care in the emerging competitive environment
◦ Measuring Outcomes – whose and what outcomes?
◦ Reporting Outcomes – linked technological systems
◦ Competences and training issues
◦ Recruitment and retention of staff
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
Nursing In The Community
Reference List(1)
• DH (2002), Liberating the Talents. Helping Primary Care
Trusts and Nursing to deliver the NHS Plan, London DoH
• UKCC (1994), The Future of Professional Practice – The
Councils Standards for Education and Practice Following
Registration. London UKCC
• NHS Next Stage Review. www.dh.gov.uk
• Sickle Cell Society (2008) Standards for the Clinical Care of
Adults with Sickle Cell Disease in the UK
www.sicklecellsociety.org.uk
• NCEPOD (2008) A Sickle Crisis? A Report of the National
Confidential Enquiry into Patient Outcome and Death.
www.ncepod.org.uk
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008
Nursing In The Community
Reference List (2)
• Rochester-Peart C.(2004) The roles and function of a community
sickle cell and thalassaemia centre In Practical Management of
Haemoglobinopathies Edited Okpala I. London: Blackwell Science.
• Thomas V N, Westerdale N. Managing sickle cell disease: the
hospital –community interface British Journal of Community
Nursing, Vol.1, Iss.8 16 Dec 1996 pp 466-471
• Smith-Wynter L, van den Akker O. The feasibility of nursing patients
with sickle cell crisis at home British Journal of Community
Nursing, Vol.4, Iss. 10 08 Nov 1999, pp531-537
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© South East London Sickle Cell and Thalasseamia Centre – Lambeth PCT September 2008