Our District Nursing service provides high quality nursing care to individuals in their own homes and residential homes across Somerset. The service works in partnership with patients, their family and carers, primary care, acute care, social care, independent and voluntary sector, specialist community health teams, older person’s mental health teams and independent rehabilitation teams.

Our district nursing teams are each led by a team leader and include community registered nurses, assistant practitioners, registered nursing associates and healthcare assistants.

Referrals

Our district nursing service will triage referrals from anyone who contacts them, such as patients, relatives, carers and other professionals, such as GPs, hospitals, hospice, care homes and social services.

Referral criteria

Our service is available to patients over 18 who are housebound and require nursing care or meet one of the following criteria:

• If you’re a post-operative patient who is temporarily unable to travel.
• If you require end of life care.
• If you are neutropenic and are undergoing chemotherapy, radiotherapy or your health condition would lead to travel or attendance at a clinic being detrimental to your treatment or recovery.
• If, in the professional opinion of the district nurse team leader, it would be appropriate to carry out your treatment or care at your home.

Provision of care

The main focus is to provide nursing care to housebound patients in the home or residential care environment. Our district nursing service offers the following planned, individualised, patient centred care:

• Assessment co-ordination and management of complex, chronic and acute nursing needs
• Holistic wound assessment and management
• Palliative care for people who are terminally ill and care of the dying
• Technical nursing interventions, for example syringe drivers, central lines or intravenous drugs
• Bereavement support
• Promotion of continence and management of continence problems
• Assessment of nursing equipment
• Nursing procedures: ear care, injections, immunisations and vaccinations.

A registered nurse from our district nursing team will undertake an initial assessment of your needs through discussion with you and your family or carer, if appropriate. All records are entered onto our electronic clinical record. We can provide you with a ‘patient care record’ if you request one. We’ll also ask for your consent to share information with other services.

Our principles for practice:

We will:

• Provide high quality, culturally sensitive nursing care in your own home
• Promote and maintain independent living
• Promote a coordinated approach to your discharge from hospital
• Reduce the incidence/frequency of admission and readmission by supporting and educating both you and your carers to seek early intervention for potentially debilitating conditions
• Adopt a public health approach to all areas of practice to reduce ill health and promote healthy lifestyles
• Promote an evidence-based approach to clinical activities
• Involve you in both the planning and provision of our services.

Response times:

• Urgent referrals will be telephoned and discussed with the receiving nurse and clinically triaged within two hours
• Non-urgent will be clinically triaged with access to service within 24-48 hours
• Routine will be clinically triaged with access to service with one-three days
• Post-operative visit access to service on specified date
• Timed visits for example, specified medication requests.

You will be discharged from the service when:

• Your treatment is completed
• When you can self-manage safely
• When you are transferred to another more appropriate service, such as social services
• When you can attend the GP Practice or clinic
• If you move out of the area.