ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Under managed care and capitated reimbursement systems, case management is a core strategy for providing high-quality, cost-effective care by decreasing fragmentation, enhancing quality, ensuring efficient use of resources, and containing costs. Although case management is used in various areas of the healthcare arena, it suffers from a lack of consensus regarding its definition, essential components, and appropriate application. The purpose of this paper is to examine the components and limitations of existing case management models, outline the competencies of an effective case manager, and present a model of advanced practice nursing case management that focuses on a continuum of care that Integrates medical and psychosocial resources to promote optimal clinical fiscal outcomes and enables patients to work as partners with the healthcare team in facilitating and maintaining their physical and emotional well-being.

ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The purpose of this article is to illustrate through case examples how homeless women experience coexisting health problems, and how they may conceal these stigmatizing health problems from others, including health professionals and shelter staff. The article will also address how nurse case managers can interact with these women so that together they can develop strategies about how to manage these complex health problems.

ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Professional Nurse Case Management began at Carondelet St. Mary's Hospital 13 years ago with a goal of delivering direct nursing services to high-risk chronically III clients in the community. Nurse case management has evolved as the healthcare delivery environment has changed. This study revisits this well-described model and assesses the impact of managed care on the practice of professional nurse case management. Concept mapping was used to describe the current practice of nurse case management at Carondelet Health Network. Professional nurse case managers modeled their practice as a series of concentric spheres, each subsuming the spheres within it. Moving from the outside to the core, the spheres represent developmental framework; practicing the Carondelet mission; group practice; Integration, education, and acculturation of clients within the health system; and client-focused therapeutic relationship. One final sphere of practice, bridging the gaps, represented actions that cross all spheres of nurse case management.

ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Transplantation has been and continues to be an Important and often life-saving treatment option for patients with end-stage organ disease. Advances in our understanding of the immunologic mechanisms of rejection have led to pharmacologic breakthroughs that are enabling unprecedented levels of success in transplantation. Today's Immunosuppressive protocols are resulting in fewer acute rejection episodes. Moreover, several of the immunosuppressive agents recently introduced have proven effective in reversing rejection considered refractory to conventional antirejection therapies. Newer monocional antibodies offer more specific immunosuppression while minimizing the incidence and severity of adverse effects often associated with immunosuppressants, especially opportunistic infections. Fewer hospitalizations for rejection and other complications, and ideally a decreased need for retransplantation, should significantly reduce healthcare costs, but the true benefit will most certainly be measured in improved patient outcomes.

ISSN:1084-3647    

出版商:OVID    

年代:1999

数据来源: OVID