title: The primary and secondary care interface: the educational needs of nursing staff for the provision of seamless care.
abstract: OBJECTIVE
  To identify nurses' perceived deficits in the knowledge and skills required to provide effective seamless care, so that appropriate training could be provided.
  
  
  BACKGROUND
  A clear understanding of nursing staff roles, skills and resources is paramount to work at the primary/secondary care interface. Nursing staff require an educational model that will provide a clear understanding of how their roles coalesce with other healthcare professionals. There is little evidence that examines the educational needs of nurses related to changing care boundaries.
  
  
  METHODS
  The study used methodological triangulation to explore these issues within current practice. Focus groups were used to generate items for inclusion in the questionnaire. Questionnaire design was based on an importance-performance analysis. This procedure has been effective in developing health care marketing strategies. A stratified random sample of nursing staff (n=722) from the participating trusts received the questionnaire, eliciting a response rate of 172 (23.8%).
  
  
  RESULTS
  Factor analysis provided a list of seven training categories in order of training need priority: information technology, awareness of roles, communications within seamless care, working across boundaries, professional issues, practice-related issues, delivery of patient/client care issues. There were no differences in nurses' training needs across NHS trusts. However, differences were highlighted for staff located in primary or secondary settings or working across the interface.
  
  
  CONCLUSIONS
  Despite there being a vast range of training issues the majority of nurses appear to have a clear idea of their training needs for the provision of seamless care. A training programme required which targets the specific needs of nursing staff working at different positions across the primary/secondary care interface.
authors.affiliation: Research Associate, School of Health Sciences/Nursing, University of Birmingham, Birmingham, UK. j.a.werrett@bham.ac.uk
authors.forename: J A
authors.initials: JA
authors.lastname: Werrett
authors.forename: R H
authors.initials: RH
authors.lastname: Helm
authors.forename: R
authors.initials: R
authors.lastname: Carnwell
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003299:Cooperative Behavior; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D004739:England; D017144:Focus Groups; D006760:Hospitalization; D006801:Humans; D007400:Interprofessional Relations; D007587:Job Description; D017145:Models, Educational; D020380:Needs Assessment / Q000458:organization & administration*; D015402:Nursing Education Research; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education* / Q000523:psychology*; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires