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Thanks Hoolihan! That does help alot. We are having a meeting next week to try to see what we can do to make this work. Yes we do use pagers & cell phones but we are piloting one or two Alpha pagers to try & cut down on the need for call backs, Also if the message doesn't need to be returned right away the message is left on our voice mail & we are paged to our phone. that way we don't have to interrupt Pt. care & can check it at our convenience. Thanks for your help, were all in this together!

Hi everyone! I need your help! I work in a hospital based Homecare, average census of around 120-150 patients. We are trying to find a case management model that REALLY works. Right now we have 4 RN's who work as "Case Managers", For the most part they do all of the Admits then assign the patient to one of the "primary" nurses (approx 7 or 8, depending on staffing) Usually the CM's do 2-3 opens a day, sometimes less, never more than 3. Caseload for primary SN is usually 5-6. Problem is with paperwork, time constraints, staffing etc. we never seem to have the time to communicate with each other and everyone seems to be just doing their own thing! There seems to be a constant battle over who is supposed to do what, sometimes the CM's open and never see the patient again, and don't seem to worry about it. Insurance calls are being missed, some primarys still want to "keep" their patients forever, (esp. nurses who have been around a while) and its a mess! Any ideas or examples of what your agencies do will be greatly appreciated!!

our policy currently is also to discard the saline 24 hours after opening. we try to use only the 250ml containers and on occasion have used unit dose3cc vials when provided by the pharmacy for small wet/dry dressings but those are expensive. I agree it does seem wasteful but I also think that this follows CDC guidelines.