District nursing assessment practice: case study findings

Patient assessment is widely acknowledged as a core element of community nursing expertise (Griffiths and Luker, 1994). With the current drive towards evidence-based practice, it is becoming increasingly important to provide sound evidence about this key aspect of community nursing practice. This article describes how district nurses' assessments of a carefully constructed simulated patient have provided new insight into community nursing expertise. The innovative approach used in this study of district nursing assessment practice is outlined. One of the simulated patients developed for the study is then described. A case study of one nurse participant who assessed this simulated patient forms the main focus of the article. The case study (one of four) is based on a synthesis of simulation and interview findings relating to a particular study participant. It reveals some interesting associations between various elements of nursing knowledge and provides important insight into how the quality and effectiveness of patient assessment may be affected by a practitioner's approach and knowledge base. The usefulness of this approach and the relevance of the findings for nursing practice and education are also addressed.