Trim primary care nursing data project report

Hdl Handle:
http://hdl.handle.net/10147/612302
Title:
Trim primary care nursing data project report
Authors:
Stafford, Siobhan; McDonald, Anne
Publisher:
Health Service Executive (HSE)
Issue Date:
Dec-2015
URI:
http://hdl.handle.net/10147/612302
Item Type:
Report
Language:
en
Description:
The plan agreed with the DPHN County Meath and the Director of the NMPDU provided for audit of one of the four PHIT registers and caseload analysis in two PHN caseloads in the Trim Primary Care Network area before consideration of full implementation of the PHIT in County Meath. The project was named the Trim Primary Care Network (Trim PCN) Nursing Data Project. The PHIT paper based framework which was developed by PHNs in LHO DNC.C using an action research methodology, is a peer reviewed and published public health nursing health information framework, an electronic format achieved proof of concept and was proposed for national roll-out in 20137. The PHIT comprises four core components: care planning, patient registration, data analysis and reporting, caseload management and caseload analysis 8,9. Patients registered in the PHIT are assigned a dependency category and a status of ‘active’ or ‘inactive’. The dependency category was developed to provide a ‘rule of thumb’ method of describing individual patient need for PHNs and is influenced by multiple factors including the dependency of the patient on the nurse, severity and complexity of a patient’s illness and care needs and the nursing time required to provide care10. There are four PHIT dependency categories; health promotion, acute care, chronic stable and chronic complex care11. Nursing records are considered ‘active’ for all persons aged 85 years and older and for persons with an assessed need for episodic or continuing care12. The caseload analysis guideline provides a further category of patient need namely ‘cause for concern’. This category was identified as a result of need arising from issues relating to; access to and self-management of care and health and safety within the home and community environment13. The PHIT definition for caseload analysis is ‘a process undertaken jointly by geographic caseload holders and their line managers at agreed intervals which will identify the quality of the nursing interventions and the nursing needs of a public health nursing service caseload. It will contribute to resourcing of the public health nursing service, to population health and PCCC service planning generally and to professional and practice development within public health nursing’14. Two PHNs, managing geographic caseloads in Trim PCN area and accountable to the ADPHN leading the project, volunteered services as members of the project working group (WG). Both PHNs had previous experience of managing geographic caseloads, registering older adult populations and compiling summary data. Both PHNs had recently moved work environments and were now managing geographic caseloads which were new to them. The County Meath equivalent of a caseload analysis is an ‘annual count’ which is a two-page quantitative document providing summary information on PHN caseload outcomes (e.g. counts of infants, older adults, those with a disability and numbers of wound dressing and clinical nursing visits) which is completed by the PHN and then returned to the ADPHN. A national requirement since 1966 is for PHNs to compile ‘a register of elderly persons, resident in their district, regular visitation of elderly persons….’ 15. This requisition has resulted in the generation of lists or censuses of older adults for each PHN geographic caseload holder nationally. These registers, where available, provide basic demographic details of older adults and indicate whether a PHN has visited in a particular year. There is no requirement that patients listed should have a care plan completed16. However, under the PHIT framework each patient registered is assessed using a standard assessment form which guides a plan of care. Patients are assessed for independence and care needs (including activities of daily living and instrumental activities of daily living) and are subsequently registered by PHNs into one of four registers (family, acute, chronic sick / disability, and older adults). All patients 65 years of age and older referred to the PHN service are eligible for registration. The two PHNs auditing the PHIT register continued to complete the traditional County Meath care plan documentation to assess, plan care for, and review OAs over the course of the project. Patients having assessments for Home Care Package (HCP) services had both traditional care plan assessments and Common Summary Assessment Records (CSAR) completed. Standard PHIT registration for OAs requires patient coding for; geography, caseload, marital and living status, diagnosis, and public health issues, self care and nursing treatment and outcome.
Keywords:
PRIMARY CARE; PUBLIC HEALTH NURSING; PATIENT NEEDS ASSESSMENT; DEPENDENCY

Full metadata record

DC FieldValue Language
dc.contributor.authorStafford, Siobhanen
dc.contributor.authorMcDonald, Anneen
dc.date.accessioned2016-06-09T10:59:11Zen
dc.date.available2016-06-09T10:59:11Zen
dc.date.issued2015-12en
dc.identifier.urihttp://hdl.handle.net/10147/612302en
dc.descriptionThe plan agreed with the DPHN County Meath and the Director of the NMPDU provided for audit of one of the four PHIT registers and caseload analysis in two PHN caseloads in the Trim Primary Care Network area before consideration of full implementation of the PHIT in County Meath. The project was named the Trim Primary Care Network (Trim PCN) Nursing Data Project. The PHIT paper based framework which was developed by PHNs in LHO DNC.C using an action research methodology, is a peer reviewed and published public health nursing health information framework, an electronic format achieved proof of concept and was proposed for national roll-out in 20137. The PHIT comprises four core components: care planning, patient registration, data analysis and reporting, caseload management and caseload analysis 8,9. Patients registered in the PHIT are assigned a dependency category and a status of ‘active’ or ‘inactive’. The dependency category was developed to provide a ‘rule of thumb’ method of describing individual patient need for PHNs and is influenced by multiple factors including the dependency of the patient on the nurse, severity and complexity of a patient’s illness and care needs and the nursing time required to provide care10. There are four PHIT dependency categories; health promotion, acute care, chronic stable and chronic complex care11. Nursing records are considered ‘active’ for all persons aged 85 years and older and for persons with an assessed need for episodic or continuing care12. The caseload analysis guideline provides a further category of patient need namely ‘cause for concern’. This category was identified as a result of need arising from issues relating to; access to and self-management of care and health and safety within the home and community environment13. The PHIT definition for caseload analysis is ‘a process undertaken jointly by geographic caseload holders and their line managers at agreed intervals which will identify the quality of the nursing interventions and the nursing needs of a public health nursing service caseload. It will contribute to resourcing of the public health nursing service, to population health and PCCC service planning generally and to professional and practice development within public health nursing’14. Two PHNs, managing geographic caseloads in Trim PCN area and accountable to the ADPHN leading the project, volunteered services as members of the project working group (WG). Both PHNs had previous experience of managing geographic caseloads, registering older adult populations and compiling summary data. Both PHNs had recently moved work environments and were now managing geographic caseloads which were new to them. The County Meath equivalent of a caseload analysis is an ‘annual count’ which is a two-page quantitative document providing summary information on PHN caseload outcomes (e.g. counts of infants, older adults, those with a disability and numbers of wound dressing and clinical nursing visits) which is completed by the PHN and then returned to the ADPHN. A national requirement since 1966 is for PHNs to compile ‘a register of elderly persons, resident in their district, regular visitation of elderly persons….’ 15. This requisition has resulted in the generation of lists or censuses of older adults for each PHN geographic caseload holder nationally. These registers, where available, provide basic demographic details of older adults and indicate whether a PHN has visited in a particular year. There is no requirement that patients listed should have a care plan completed16. However, under the PHIT framework each patient registered is assessed using a standard assessment form which guides a plan of care. Patients are assessed for independence and care needs (including activities of daily living and instrumental activities of daily living) and are subsequently registered by PHNs into one of four registers (family, acute, chronic sick / disability, and older adults). All patients 65 years of age and older referred to the PHN service are eligible for registration. The two PHNs auditing the PHIT register continued to complete the traditional County Meath care plan documentation to assess, plan care for, and review OAs over the course of the project. Patients having assessments for Home Care Package (HCP) services had both traditional care plan assessments and Common Summary Assessment Records (CSAR) completed. Standard PHIT registration for OAs requires patient coding for; geography, caseload, marital and living status, diagnosis, and public health issues, self care and nursing treatment and outcome.en
dc.language.isoenen
dc.publisherHealth Service Executive (HSE)en
dc.subjectPRIMARY CAREen
dc.subjectPUBLIC HEALTH NURSINGen
dc.subjectPATIENT NEEDS ASSESSMENTen
dc.subjectDEPENDENCYen
dc.titleTrim primary care nursing data project reporten
dc.typeReporten
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