Public health nurse seeking advice on caseload?

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    I am a new employee working for a health program that specializes in helping long term care clients return to their communites, either through assisted living, independant livings, or in their own homes. I am the programs first and only nurse to date. I was hired on with the specific purpose of managing a case load of medically complex clients. The program has never offered this service before and will only take patient's by referral. I have been asked to choose what criteria qualifies a patient as medically complex, and hence will be choosing what patients will be in my caseload.

    The population I serve must qualify for nursing home level of care, so a great majority already have multiple medical complications. Does anyone have suggestions on what type of situations would qualify a patient with nursing home level of care to be "exceptionally" medically complex? Initially I intend to take any patients who are referred to the program, but I would like to provide some general examples to my providers as examples of what a patient they refer might look like?

    Any suggestions on criteria or examples of an "exceptionally medically complex" nursing home patient would be appreciated

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  2. 1 Comments...

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    Medically complex could refer to patients that have more than X nursing diagnoses across multiple categories that still have independant functioning.

    You could probably pull out your nursing diagnosis textbook and pull random nursing diagnosis bullets and put them together for a sample patient, or even take a look at a chart that is already in your candidate pool if you have one.

    You may need to come up with your own criteria worksheet, detailing specific diagnosis and scoring for each to determine candidacy, with disqualifiers for disabilities that they would need to stay in long-term care to receive their proper standard of care.

    Hope that made sense.


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