Evidence map›Paper›PMID 40765124›Full record

ArticleInternational nursing review2025

The Delineation of Advanced-Level Practice Within UK District Nursing: A Cross-Sectional Comparative Study Before and After Policy Implementation.

John Unsworth, Crystal Oldman, Joanne Atkinson, Dania Comparcini, Valentina Simonetti, Giancarlo Cicolini, Kristina Mikkonen, Marco Tomietto

Abstract readComparative Study
In one paragraph

Article in International nursing review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Experiential Learning and Educational Competence Among Registered Dietitians in Japanese Hospitals: A Nationwide Cross-Sectional Study.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

John UnsworthDepartment of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0002-4150-6513
Crystal OldmanThe Queen's Nursing Institute, London, UK.ORCID https://orcid.org/0000-0001-7135-658X
Joanne AtkinsonDepartment of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0003-0823-0110
Dania ComparciniSection of Nursing, Interdisciplinary Department of Medicine, Aldo Moro' University of Bari, Bari, Italy.ORCID https://orcid.org/0000-0003-3622-6370
Valentina SimonettiDepartment of Innovative Technologies in Medicine and Dentistry, G.d'Annunzio' University of Chieti, Pescara, Italy.ORCID https://orcid.org/0000-0002-7185-4850
Giancarlo CicoliniDepartment of Innovative Technologies in Medicine and Dentistry, G.d'Annunzio' University of Chieti, Pescara, Italy.ORCID https://orcid.org/0000-0002-2736-1792
Kristina MikkonenDepartment of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0002-4355-3428
Marco TomiettoDepartment of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0002-3813-1490

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAdvanced practice nursing is key in response to increasing healthcare demands and the need for Universal Health Coverage. District nursing, which involves care for people in their own homes, has undergone a significant transformation to manage complex long-term conditions and reduce hospital admissions.

aimThis study aims to identify the advanced practice domains of UK district nurse team leaders, before and after policy reforms designed to prevent unnecessary admission to hospital. A secondary aim is to compare the advanced practice domains of district nurse team leaders with those of advanced practice nurses working in family and community nursing.

methodsA cross-sectional study was conducted. Data were collected via an online survey using the Family and Community Nursing Advanced Practice Scale, assessing five key domains of advanced practice. The study employed ANOVA and t-tests to compare groups.

resultsA total of 448 district nurse team leaders participated in this study, and secondary data from 548 family and community nurses were retrieved. No significant differences were found across qualification groups for most advanced practice domains, except for medication prescribing. Comparisons with advanced practice nurses in family and community settings revealed significantly higher scores in all domains and similar scores in leadership competencies. DISCUSSION: Experiential learning plays a crucial role in developing advanced practice competencies beyond formal qualifications. The results align with Kolb's theory, highlighting the importance of clinical exposure and mentorship in shaping advanced nursing skills.

conclusionDistrict nurse team leaders exhibit key advanced practice competencies. Credentialing frameworks may help formally recognise the expertise developed through clinical experience. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Policymakers should consider enhancing experiential learning opportunities and credentialing systems to support district nurses in their transition to advanced practice.

Indexed as

Advanced Practice NursingClinical CompetenceCommunity Health NursingHealth PolicyAdultCross-Sectional StudiesFemaleHumansLeadershipMaleMiddle AgedSurveys and QuestionnairesUnited KingdomAdvanced practice nursingdistrict nursingnursing rolesUnited Kingdomworkforce

Identifiers

PMID40765124
PMCPMC12326113

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.