NUR 39900 Case Management Purdue University

NUR 39900 Case Management Purdue University

NUR 39900 Case Management Purdue University

Overview: At this point in the course, I am hoping that you will be able to combine what you have learned, along with your work experience, to analyze the cases you choose to arrive at a plan of action that will benefit the patient and achieve your case management goals.

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Directions

CASE MANAGEMENT CASE STUDIES

The following five cases represent five patients that might well be referred to a case manager for help in determining discharge needs.  You are to use what you have learned about case management principles, processes, and tools to determine how these cases should be handled. You can add imaginary information to the cases if it fits in well.  Choose 3 of the 5 cases, each worth 10 points, and thoroughly discuss each case (one page, doublespaced, for each case).  Cite your sources, include a cover sheet, and use APA format .

CASE MANAGEMENT:  CASE 1

You work as a case manager at a local hospital.  You have been assigned Henry Owens, because his admission raised red flags.  Mr. Owens is 61 years old and has just suffered his second MI in 2 years.  He arrested with the second MI and is now in the cardiac care unit.  He is employed and travels a lot with his job.  He is now worried about losing his job.  He is 25 pounds overweight, and, according to his wife and 2 grown children, has not been compliant with treatment since the first MI.

CASE MANAGEMENT: CASE 2

On January 6, during a deep freeze, George Thomas, a 48 year old homeless man, was brought to the emergency department by the local fire department ambulance after being found sleeping under a viaduct.  George was suffering from hypothermia and had severe frost bite to his left ear and left hand.  He is admitted to the ICU initially, and, after 5 days and 2 surgeries to remove dead tissue, is transferred to a medical/surgical unit.

CASE MANAGEMEN: CASE 3

Louise Riley, a sixteen year old patient with Type 1 diabetes and a Hemoglobin A1C of 9.4 admits that she is tired of having to be different from the other kids her age, and she has not been following her diet regimen.  Louise was diagnosed in Type I diabetes at age 5, and had been well controlled until 2 years ago.

CASE MANAGEMENT: CASE 4

Marvin Helms is a 74 year old male with multiple decubiti on coccyx, heels, buttocks, elbows, and left ear.  He has Acinobacter and MRSA.  All limbs are contracted and the he is unable to turn without assistance.  He  has been treated for sepsis.  He came from home where his daughter is the caregiver.   She insists on taking her father home upon discharge.  She wants the rectal tube and foley out.  The daughter lives on the father’s social security and does not want to pay for a nursing

home.

CASE MANAGEMENT: CASE 5

Arthur Radcliff, a 67 year old male with congestive heart failure, has been admitted 8 times in the past 4 months.  He lives with his wife and adult son, and they are very concerned about his condition.  You have determined that Arthur has received volumes of discharge information which he claims to understand, but he is still readmitted frequently.

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GRADING RUBRIC

Final Paper: 3 cases, each worth 10 points	Thorough answers to all three cases with 2 or less grammatical errors	Thorough answers with more than a few grammatical errors, or a small admission in thoroughness	Missing or incomplete answers, or multiple grammatical errors	Incomplete, missing, or poor responses, late paper, or many grammatical errors
30 Points	30	29-22	21-14	14-0

NUR 39900 Case Management Purdue University Sample

Case 2

The scenario involving George Thomas is rather complicated, and there are a lot of concerns that require solutions. The present state of his functioning abilities is one of the things that has to be looked at. To begin, it is essential to find out whether or not Mr. Thomas has had evaluations by physical therapists and occupational therapists. If he has not been evaluated, It is imperative that the doctor orders these procedures so that we can get an accurate picture of Mr. Thomas’s previous and present functional status. Mr. Thomas’ medical personnel will have a better understanding of his abilities after he has been evaluated by occupational and physical therapists. Before admitting him to the hospital, a personalized treatment plan should also be devised with the goal of restoring him to his previous level of functionality.

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Mr. Thomas should proceed with his treatment regimen after being moved to the med-Surg unit until he is prepared for the subsequent change in care. Given the fact that Mr. Thomas did not have a home before his admission to the hospital, determining his future placement before he is discharged is of the utmost significance. This is also significant since it will lessen the likelihood that he may have to return to the facility within a short period after being discharged. After Mr. Thomas has been discharged from the hospital, the case manager will be able to assist in locating appropriate services for him. This includes places he can go to get something to eat, a place to sleep, clothing, medication, and perhaps even a job (Ponka et al., 2020). Additionally, the case manager will assist in making arrangements for transportation to the subsequent location. It is because of this that Mr. Thomas will not have to risk getting hypothermia once more by walking about in the cold weather.

Case 3

It is difficult for a young person like Louise to deal with a chronic condition like diabetes when most of her peers are not. She needs to be reassured that she’s not the only teenager with diabetes, even if her peers don’t have her condition. The emphasis should be on connecting her with other individuals her age who suffer from diabetes through community or internet resources (King et al., 2017). At this point in her life, maintaining her blood glucose levels and taking her medicine is less essential to her than the interactions she has with her friends.

Peer interactions, emotional well-being, and the control of blood sugar are the three outcomes that are highlighted most often (Ye et al., 2017). When an adolescent is diagnosed with the condition that they are aware has the potential to take their life and that they have to deal with for the rest of their lives, this may be a lot to take in. For Louise, the first step is to recommend that she see a counselor handle her psychological well-being and the burden of managing blood sugar levels. Identifying the factors that have contributed to her non-compliance in the previous two years is critical in order to remedy it.

Case 4

The case of Mr. Helm is one that is both distressing and quite severe. Because he presented to the facility with many decubitus ulcers on a variety of body regions, it is clear that his daughter has not been providing him with enough care as a caregiver. He was obviously being left in the same spot for a very long time. It’s no surprise, therefore, that he ended up with pressure sores all around, even in his ear. The presence of a sore on his ear illustrates how completely he is reliant on others since he cannot turn his head. Given the clear negligence and abuse that has occurred here, it is imperative that social services be consulted. Mr. Helm’s daughter’s reliance on his social security money means that she is unfit to be his carer and is hindering her father from receiving the proper healthcare attention he requires. It is the responsibility of the case manager to investigate Mr. Helm’s living wills and determine who Mr. Helm has named as his POA, as well as whether or not he has any instructions at all. Unless Mr. Helm had access to home care services or acquired a caregiver, he would be unable to go home after his discharge (Phelan, 2018). However, his daughter will not pay for any of these options since she does not want to pay for a nursing home for her father. Based on Mr. Helm’s insurance, the case manager could investigate his plan and determine whether or not he would be eligible for Medicaid to stay in a county nursing facility. As a result, there is a possibility that his daughter may have a more favorable attitude about his moving into a nursing home once he is discharged from the hospital. The necessary medical attention would be made available to him in the event that he was admitted to a nursing home that was paid for by his health care coverage.

References

King, K. M., King, P. J., Nayar, R., & Wilkes, S. (2017). Perceptions of adolescent patients of the “Lived experience” of type 1 diabetes. Diabetes Spectrum, 30(1), 23-35. https://doi.org/10.2337/ds15-0041

Phelan, A. (2018). The role of the nurse in detecting elder abuse and neglect: Current perspectives. Nursing: Research and Reviews, 8, 15-22. https://doi.org/10.2147/nrr.s148936

Ponka, D., Agbata, E., Kendall, C., Stergiopoulos, V., Mendonca, O., Magwood, O., Saad, A., Larson, B., Sun, A. H., Arya, N., Hannigan, T., Thavorn, K., Andermann, A., Tugwell, P., & Pottie, K. (2020). The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review. PLOS ONE, 15(4), e0230896. https://doi.org/10.1371/journal.pone.0230896

Ye, C. Y., Jeppson, T. C., Kleinmaus, E. M., Kliems, H. M., Schopp, J. M., & Cox, E. D. (2017). Outcomes That Matter to Teens With Type 1 Diabetes. Diabetes Educator, 43(3), 251–259. https://doi.org/10.1177/0145721717699891