QUALITY OF CARE OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE PROVIDED BY SPECIALIZED COMMUNITY NURSES - A PROCESS EVALUATION

An ageing population, shorter periods of hospitalization, and advances in medical technology have meant that community nurses have become in creasingly confronted with patients demanding skilled and specialized nursing care. The quality of care provided by 47 general and eight spe cialized community nurses was studied in a group of 115 patients with severe chronic obstructive pulmonary disease (COPD) after discharge fr om hospital. Four process variables were studied: the content of the h ome visit, the time spent on the home visit, the quality of the report , and the number of home visits. Results show that the content of the home visit differed between general and specialized community nurses. General nurses were more focused on analysing care needs and specializ ed nurses paid more attention to psycho-social problems. The number of home visits and the time spent on the care provided did not differ si gnificantly between both groups. The quality of the report of speciali zed nurses was significantly higher. In conclusion, specialized commun ity nurses demonstrated a higher clinical competence in the care of pa tients with COPD. Further research is required to conclude whether pos itive changes in nursing process result in positive patient outcomes.