Referrals to a District Nurse

If a patient requires referral to a district nurse at home, complete a district nurse referral form. There are three types of referral forms,

• Standard - blue
• Central Venous Catheter/Chemotherapy infusors - green
• Peripherally inserted central catheter/Chemotherapy infusors - yellow.

These are supplied to all wards/departments. Referrals will be accepted from any member of the multidisciplinary team.

State the date you require the first visit - bearing in mind that this is a request only. The district nurse will need to prioritise their own workload and will make their own assessment when they visits, about how often the team needs to attend once the patient is at home. NEVER PROMISE A PATIENT 'DAILY' VISITS OR INFORM THEM OF A VISIT TIME. If the patient requests this information please ask the district nurse team to contact the patient by telephone as soon as possible. Visit time, frequency etc is not something hospital staff have jurisdiction over and may lead to unrealistic expectations for the patient and family. If you need to know how often nurses are likely to visit, contact the district nurse team direct and ask!

Be clear on the referral what exactly you want the district nurse to do/reason for visit. Unless patients are imminently terminal, it is not usually possible for district nurses to offer personal care (washing and dressing). This is provided in most areas by social service carers (arrange through the social work department). District nurses provide support in many ways - from help with symptom control, pain relief, emotional support/contact visits, pressure area care, catheter care, administration of medicines not taken orally (with authorization letter), and so on.

Try to include a description of how the patient is generally. Remember mobility issues (in case patient is at risk on the stairs) etc. Always refer to physiotherapy and occupational therapy if you are concerned about a patient's safety, prior to discharge. See separate checklist, which provides guidance on things you should tell the district nurse when referring.

Once completed, the TOP copy of the referral form should be faxed onto the relevant team of district nurses and then should go in the ward box file for future reference. These should be kept for 4 weeks only and then destroyed. The carbon copy should be given to the patient/carer to pass to the district nurse in the patients home.