Made to measure? Assessing feasibility of quality indicators for district nursing.

Scant empirical information exists regarding the quality of district nursing (DN) services. This article reports the testing of 31 quality indicators (QI) in practice. Method: Twelve DN teams provided patient notes for audit. External auditors completed audit forms by cross-referencing between DN office records, patient notes from home, electronic GP records and discussions with DN team leaders. A patient experience questionnaire was piloted. Findings: 277 (77%) patients' records were audited. Access to records was problematic. QIs required further refinement of their wording, modification of inclusion criteria, deletion of some QIs and inclusion of others. Telephone administration of the patient experience questionnaire was not feasible for the DN patient population. Conclusions: QIs can not be used 'off the shelf' and need testing and modification before routine use. Trained, external auditors with clinical backgrounds ensure an informed, uniform, objective approach to data collection, which is desirable as QIs might inform commissioners in a competitive field in future. [ABSTRACT FROM AUTHOR]