title: Multiple stakeholder views on changes in delivery of public health nursing services in Ireland.
abstract: In contrast with community nursing services in the UK and other parts of the world, the public health nursing service in the Republic of Ireland operates as a generalist service, providing both public health and wellbeing services in addition to clinical nursing services to a wide range of patient groups. While much discussion has taken place over the years about the benefits and challenges of a generalist service, little consensus has emerged about whether the current generalist approach should be maintained or whether a more specialised approach is required. This article presents key findings from an evaluation, using research methods, of a community nursing service that was restructured from a generalist, geographically based service, to a more specialist team-based model. The findings across multiple stakeholders show a number of positive effects in the areas of quality, safety, risk, governance, active caseload management, and finances. Some challenges were also identified, particularly with respect to continuity of services, loss of expertise, role of the team leader, and engagement in population-based activities.
authors.affiliation: Visiting Research Fellow, Trinity College Dublin, Ireland.
authors.forename: Sinead
authors.initials: S
authors.lastname: Hanafin
authors.affiliation: Senior Researcher, Research Matters Ltd, Ireland.
authors.forename: Emma
authors.initials: E
authors.lastname: Dwan O'Reilly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D003152:Community Health Nursing / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011637:Public Health Nursing / Q000458:organization & administration*; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom; D055815:Young Adult
keywords: Community health nursing; Ireland; Nursing models; Public health; Specialist