title: Reliability and validity of the CCNCS: a dependency workload measurement system.
abstract: OBJECTIVE
  To refine, test and evaluate the Community Client Need Classification System (CCNCS).
  
  
  BACKGROUND
  Workload assessment in community nursing is complicated by the range of services that may be delivered in one patient interaction. The CCNCS is a workload measurement system designed to capture the direct and indirect elements of community nursing work and is suitable for use with all care groups in the community.
  
  
  METHODS
  Survey.
  
  
  METHODS
  Forty-four community nurses implemented the CCNCS with all clients in their caseload for four weeks. Community nursing in the Irish Republic is known as public health nursing. The Public Health Nurses (PHNs) recorded the total time in minutes that was spent on each client each week. The satisfaction with and experiences of PHNs using the CCNCS during the study period was also recorded.
  
  
  RESULTS
  Participants endorsed the utility of the CCNCS for use in community nursing. Inter-rater and intra-rater reliability results were positive with high level of agreement between raters in relation to scoring community clients. The amount of time the PHNs spent with clients correlated with ascending level of client need.
  
  
  CONCLUSIONS
  The CCNCS affords insight into the complex nature of community nursing. It discriminates between levels of need and has potential to provide a standardised assessment of need in all community-nursing clients. Adequate resources are required to conduct further testing of the reliability and predictive validity of this system.
  
  
  CONCLUSIONS
  The CCNCS can provide objective evidence of community nursing workload and thus facilitate workforce planning.
authors.affiliation: Trinity College Dublin, Dublin, Ireland. anne-marie.brady@tcd.ie
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Brady
authors.forename: Gobnait
authors.initials: G
authors.lastname: Byrne
authors.forename: Paul
authors.initials: P
authors.lastname: Horan
authors.forename: Catriona
authors.initials: C
authors.lastname: Macgregor
authors.forename: Cecily
authors.initials: C
authors.lastname: Begley
mesh_terms: D003153:Community Health Services; D019538:Health Care Surveys / Q000592:standards*; D006801:Humans; D007494:Ireland; D020380:Needs Assessment / Q000145:classification*; D011637:Public Health Nursing; D016526:Workload / Q000706:statistics & numerical data