Advancing District Nursing Care: Enriching evidence, embracing outcomes, and evolving through continuous learning

District nursing care faces significant societal challenges due to ageing populations and a shortage of healthcare professionals. This dissertation emphasises the need for more scientific underpinning and the utilisation of patient outcomes to facilitate learning and improvement in district nursing practice, ensuring quality of care. The research investigates the current use of district nursing care, the impact of the COVID-19 pandemic on this field, and relevant nurse-sensitive patient outcomes. It explores how these outcomes are measured in practice and what is necessary to utilise them for learning and improvement.

The dissertation shows that evidence for district nursing care is scarce, underlining the importance of producing methodologically strong evidence. Furthermore, this dissertation demonstrates that the use of patient outcomes for learning and improvement is limited. This advocates for a different approach to implementing learning and improvement through patient outcomes. It is important to prioritize patient outcomes and create a culture of continuous learning and improvement. To achieve this, it is necessary to uniformly measure patient outcomes, optimize information systems for learning and improvement, support and empower district nursing care professionals, strengthen collaborations between professionals and stakeholders, and enhance integrated care. Achieving progress in district nursing care necessitates a reconsideration of the current organisation and funding of healthcare. By proactively strengthening the scientific evidence for district nursing, making patient outcomes an integral part of district nursing care provision, and promoting continuous learning and improvement, the quality of care in district nursing can be ensured, both now and in the future.