Reliability and validity of the CCNCS: a dependency workload measurement system.

AIM: 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.

DESIGN: Survey.

METHOD: 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.

RELEVANCE TO CLINICAL PRACTICE: The CCNCS can provide objective evidence of community nursing workload and thus facilitate workforce planning.