1.3.1 The contribution of nurses to chronic disease management in England (261)
Alison While, Professor of Community Nursing, Florence Nightingale School of Nursing & Midwifery, King's College London, United Kingdom Co authors: Billie Coomber & Angus Forbes
Abstract:
Background:
Chronic disease management is a major challenge to the NHS. Nurses are the largest group of healthcare professionals and Government policy has proposed an increased role in the management of chronic disease care delivery.
Aims:
To identify and categorise the contribution of nurses (established and novel) to different chronic disease management systems for patients with diabetes, multiple sclerosis and chronic obstructive pulmonary disease.
Methods:
A stratified random national postal survey of lead nurses (n=296; 70% response rate; diabetes n=102; multiple sclerosis n=75; chronic obstructive pulmonary disease n=118) working in NHS Trusts delivering primary, secondary and tertiary care was undertaken in 2007.
Results:
There was evidence of hierarchical (consultant nurses) and lateral (nurse practitioner) role expansion. The contribution of generic staff nurses was under-reported. Different patterns of contributions to care were reported across the disease trajectories and across the three disorders. Thus respondents reported a limited nurse contribution to the initial diagnosis but major nurse contributions after diagnosis including a range of nurse-led services during the initial treatment phase. Major nurse contributions and nurse-led services were reported within services for long-term/continuing care, management of complications and for the delivery of advanced disease care. The respondents from the different disorder groups ranked the importance of care activities within their roles differently (emotional support, information giving, clinical assessment, symptom control, medicine management, managing the care environment, care coordination). Most respondents reported approaches to measuring and assuring the quality of care within their practice areas with clinical audit, benchmarking and clinical supervision being most frequently identified.
Conclusions:
Nurses are making major contributions to chronic disease management across primary, secondary and tertiary care services. The roles of nurses are changing with the growth of nurse-led as well as nurse-delivered services.
Biography:
Alison While is Professor of Community Nursing at King’s College London. Over the last 20 years she has undertaken an extensive portfolio of research related to nursing roles. Most recently she has been focusing her research on new nursing roles and chronic illness care. She has also supervised a large of nursing PhDs.