CASE MANAGEMENT AT A COMMUNITY NURSING CENTER.
Contributors: University of Wisconsin--Milwaukee.
Published: 1993
Number of pages: 202
Subjects: Health Sciences, Nursing.; Health Sciences, Public Health.
Description: The purpose of this study was to describe the nature of case management within the context of a Community Nursing Center (CNC). At the CNC studied, a standardized framework for documentation of nursing practice based on the Omaha System classification was used. Data from 514 CNC client health records and two group interviews with five CNC nurses were examined.

Sequential methodological triangulation was used, including both quantitative and qualitative methods. The prevalence of and relationship among selected nursing care elements of the Nursing Minimum Data Set (NMDS) and demographic variables were examined in the quantitative analysis that included the use of descriptive statistics, chi square tests, Mann-Whitney U tests, and logistic regression analysis. Content analysis was used to examine qualitative data collected through group interviews with the CNC nurses.

Findings from this study clearly indicated that clients who were provided direct access to nursing care services do use these services. In addition, findings empirically supported nursing case management as a strategy advanced practice nurses used in providing primary health care services at a CNC, as evidenced by case management documented as an intervention for 75% of the clients.

Nurses used similar concepts to describe both case management and primary health care in their practice. Although certain nursing diagnoses were more commonly case managed within specific demographic groupings, case management was utilized as a nursing intervention based on the individual assessment of each client by a nurse. Complexity of client need, intensity of care, and number of different nursing intervention categories were all significant predictors of case management.

Implications for health care policy included the need to endorse CNCs as equal delivery structures within the health care system thus promoting nursing case management as a viable option for consumers. Clearly, direct reimbursement for advanced practice nursing services would support the further development of CNCs.

The NMDS provided the framework for the collection and organization of standardized data used to examine client needs and nursing care. Expansion of current health care data bases to include the elements of the NMDS is recommended.
Notes: Source: Dissertation Abstracts International, Volume: 55-05, Section: B, page: 1800.

Thesis (PH.D.)--THE UNIVERSITY OF WISCONSIN - MILWAUKEE, 1993.

School code: 0263.