Thesis on "Nursing Nurse Case Management"

Thesis 4 pages (1316 words) Sources: 6 Style: APA

[EXCERPT] . . . .

Nursing

Nurse Case Management

The term case management has been used in community health settings for many years, but is relatively new to the acute care setting. Case management, as defined in some hospitals, has little similarity to case management programs among hospitals. Case management has been used to describe a wide variety of programs and services in the hospital setting. Many nurses and other health care professionals are often confused about how case management compares with nursing care delivery systems (Lyon, 1993).

The practice of case management depends a great deal on the type and structure of the particular organization. Although case managers come from many disciplines, most have a background in nursing or social work. Nurses are well matched to the role because the functions of case management closely follow the framework of the nursing process: assessment, planning, implementation, and evaluation. Case management as a process widen this framework and incorporates additional components, such as patient identification or case selection; resource identification; advocacy; coordination, monitoring, and evaluation of care; data collection and analysis; and documentation of multiple outcomes, including cost, quality, and client status (White, and Hall, 2006).

Case Management nursing duties include assessing and monitoring patients and determining eligibility for treatments. This is done by making use of clinical pathways in order to determine whether the plan of care being provided meets the patient's needs, and arranging for additional services as needed in order to help patients achieve desired outcomes. A Case Management Nurse carries out research, analyzes data, and coordinates patient care with all members of the patient's health care team while providing each patient with individual planning and planning in order to ensure optimum outcome while also seeking to ensure care and services provided are appropriate to patient needs and cost effective (Case Management Nursing Career Profile, 2006).

Hospital-based or acute care management is also referred to as episodic case management. This type of case management is applied to patients during an episode of illness that is short-term. This model uses the staff nurse in the position of case manager. In addition to hands on direct nursing care, they are also responsible for indirect nursing functions that include: physical assessments, medication administration, intravenous administration, wound management and patient/family education (Cesta, and Tahan, 2002).

The goals of acute case management often include: encouraging timely discharges, prompt, efficient use of all available resources, achievement of expected outcomes, collaborative practice, coordination of care across the continuum, and performance improvement activities which lead to optimal patient outcomes (Cohen, and Cesta, 2005).

A nurse case manager can be used in three different ways. The first is as a Utilization Review Manager. These case managers are responsible for reviewing charts for the use of interdependent hospital systems, timeliness of service as well as safe and appropriate utilization of services. The Utilization Review Manager Nurse works closely with the physician for monitoring quality services to the patient. If after reviewing the patient's stay and utilization of services, a patient no longer needs the stay in an acute care setting, the Utilization Review Manager Nurse may request that the patient have outpatient or other services provided for the patient to the attending (Case Management, 2009).

The second type of acute care case manager is that of Quality Manager. The QM or QRM nurse is accountable for the overall quality of care being delivered. This nurse may also be found in the Risk Management office working with the hospitals risk management team, 'putting out' any legal fires that may occur during a patient's hospital stay (Case Management, 2009).

The third type is that of Discharge Planner. A discharge planner is a nurse that coordinates all the aspects of a patient's admission and discharge. This nurse evaluates all high-risk patients, with high-risk diagnosis, i.e. stroke, MI, complicated pneumonia. It is the discharge planner that often acts as an investigative reporter, making available all the social and financial resources that the high-risk patient may… READ MORE

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