Nurses as Case Managers Model

Specialties LTC Directors

Published

My facility is currently considering various nursing models. We have had unit managers in the past but as I have stated in previous post, that role has not been very effective. I was wondering if anyone has used a nursing model where the nurse was responsible for a certain number of residents, probably around 8. The nurse would be responsible for MARS and TARS, careplan check, labs, family conferences, skin checks, concerns/complaints. Just wondering if anyone else has used this model. If so, was it successful? Also, any suggestions on additional tasks the nurse would be responsible for managing?

heron, ASN, RN

4,137 Posts

Specializes in Hospice.

Sounds like the original primary nursing model. The hitch came when the pts needed care during the other 128 hrs a week when the primary wasn't on duty.

txdon

82 Posts

If the "primary" nurse is not on duty, the responsibility would fall on the nurse who is on duty. The "management" part would be that of the "primary" nurse. I am in desperate need trying to figure out an effective nursing staff model. Our facility holds up to 90 residents, but usually has between 80-85. We have 3 LTC units and I skilled. Skilled hold up to 20. Currently we have one unit manager for one side, which consists of 1 LTC hall and skilled. I am desperate to hear from other DON's who have ideas as to what has been most effective.

tewdles, RN

3,156 Posts

Specializes in PICU, NICU, L&D, Public Health, Hospice.

Consider the hospice case management model as used in LTC/ALF.

That RN will be responsible for 12-25 patients in one or more facilities (depending upon the composition of the team). That responsibility includes the MAR, POC, all aspects of pt assessment including skin, nutrition, comfort (you know what hospice nurses do), family conferences, etc.

When the RN case manager is not working the other team members (which includes other nurses) follow the POC as written and directed by the CM. The CM incorporates the other professional disciplines into the team and POC. The team must meet regularly to review and update the POC.

I think it sounds like a good idea and wish you luck.

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