Care Management
a program or process that establishes systems; monitors the health status of individuals, families, and/or groups; and develops planning and intervention activities and targeted evaluation outcomes for the client and program
Case Management
includes the activities implemented with individual clients in the system
Care management strategies (5)
use management; critical paths; disease management; demand management; and case management
Process of Advocacy
-Informing clients about the nature of their choices
-Supporting the clients choice, its their right
-Affirming the clients decision is consistent with their goals
-Systematic problem solving (ADPIE)
Advocacy
activities for the purpose of protecting the rights of others while supporting the client's responsibility for self-determination
Techniques of Conflict management (5)
-Using a range of active communication skills directed toward learning all parties' needs and desires
-Detecting areas of agreement and disagreement
-Determining abilities to collaborate
-Assisting in discovering alternatives and valuable activities for r
The Nursing Process
1. Assessment
2. Diagnosis
3. Goals/Planning
4. Implementation
5. Evaluation
Case Management Process
1. Case finding, Screening, Target pop.
2. Identify the problem
3. Problem prioritizing, Planning to address care needs.
4. Advocating of clients interests
5. Arrangement of delivery of service, reassessment.
What are the 5 Rights of case management?
1. right care
2. right time
3. right provider
4. right setting
5. right price
Case Manager Roles
Broker, Consultant, Coordinator, Educator, Facilitator, Mentor, Negotiator, Patient Advocacy, Researcher, Systems allocator. (Pg. 241)
Best Practice Health Care Map (BPHM)
1. Client centered
2. Scientifically based
3. Population outcomes based
4. Refined through quality assessment and compared to other maps
5. Individualized to each client
6. Compatible with the larger system or health care agency.
Life Care Plan
A customized, medically based document that provides assessment of all present and future needs (medical, financial, psychological) including services, equipment, supplies and living arrangements for a client.
Liability concerns of case managers exist when the following conditions are met when?
-The provider had a duty to provide reasonable care
-A breach occurred through an act or omission to act
-The act or omission caused injury or damage to the client
Mediator
A role in which the nurse acts to assist parties to understand each other's concerns and to determine their conclusions concerning the issues. The mediator has no authority to decide on behalf of another.
Mediation
An activity in which a third party attempts to provide assitance to those who may be experiencing a conflict in obtaining what they desire.
Problem-Purpose-Expansion Method
1. Restate the problem
2. Expand the problem statement so that different solutions can be generated. (Pg. 245 Box 13-6)
Levels of prevention in Case Management (Primary)
Use the information exchange process to increase the client's understanding of how to use the health care system.
Levels of prevention In Case Management (Secondary)
Use case finding to identify existing health problems.
Levels of prevention in Case Management (Tertiary)
Monitor the use of prescription medications and adherence to treatment to reduce risk of illness complications.
Negotiating
A strategic process used to move conflicting parties toward an outcome.
Assertiveness
The ability to present one's own needs
Cooperation
The ability to understand and meet the needs of others.
Beneficence
Ethical principle stating that one should do good and prevent or avoid doing harm.
Justice
An ethical principle that claims that equals should be treated equally and those who are unequal should be treated differently according to their differences.
Nonmaleficence
means "do no harm
Veracity
Truth telling, is absolutely necessary to building a trusting relationship with a client.
True or false: Documenting case management activities and outcomes is essential to nursing practice in the community?
TRUE