An evaluation of the community nursing care in Malta

Abstract

Community nursing services are becoming increasingly important in an era associated with an ageing population and decreased informal assistance. In Malta, institutional health care services are regulated by the Public Health Regulatory Directorate however this is not fully extended to community nursing services. Within this context, the purpose of this study was to evaluate community nursing services in Malta. Standards of care from United Kingdom and Australia were used as a guide for this evaluation. A telephone survey was carried out with the service users and a 77% response rate was achieved. Face to face structured interviews were done with both public and private service providers. The majority of service users were above the age of 65 years with the most prevalent being the 75 - 84 age groups. 46% use the service on a daily basis. The most common conditions leading to service usage were diabetes, circulatory problems and needs associated with old age. Although service users expressed satisfaction there were a number of concerns identified in particular towards the lack of flexibility and reliability in the service provision. Findings indicate that the public community nursing service is not customer oriented. The current set up may act as a discouraging factor towards the promotion of client independence which in itself can result in making the service ineffective. Caregivers were more willing to discuss concerns about the service than patients. The private sector operates on a different level whereby care is provided on a demand basis and the ability to pay. The agency stated that care is customer focused however, due to the lack of private clients participating, no conclusion could be made. Finally, recommendations, based on the findings obtained, were made towards service providers, public health management, and research.

Keywords: Community nursing services, home nursing care, domiciliary care, evaluation and standards of quality care.