Clinical Nurse Specialist Role in Development of a Disease Management Program

2.50
Hdl Handle:
http://hdl.handle.net/10755/149387
Type:
Presentation
Title:
Clinical Nurse Specialist Role in Development of a Disease Management Program
Abstract:
Clinical Nurse Specialist Role in Development of a Disease Management Program
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Bandos, Jean
P.I. Institution Name:Major Hospital
A small community hospital identified the need for a diabetes disease management program to improve patient care and outcomes. The clinical nurse specialist was chosen to lead the initiative and develop an evidence-based practice model. The CNS role was to 1) analyze organizational structure and current processes related to diabetes education and management, 2) evaluate current patient outcomes and identify best practice models, 3) develop interventions based upon research and standards of care, and 4) create a multi-disciplinary chronic disease management program to be implemented across the continuum of care. The purpose of this presentation is to describe the clinical nurse specialist’s influence in development of the diabetes disease management program. One goal of disease management is the patient’s ability to access health care and to understand self care management skills. A sample of 800 patients with a diagnosis of diabetes was collected from claims data. A stratified random sample of 238 patients was selected. Insurance claims along with physician and hospital records were audited to identify the current level of diabetes disease management compared clinical practice recommendations published by the American Diabetes Association. The initial audit provided the CNS with baseline data to establish areas for improvement in the documentation of key clinical recommendations for care. The audit demonstrated a lack in documentation in the following areas: annual physician visit 32 %, blood glucose results 50%, HgA1C levels 61%, microalbumin levels 86%, and foot exams 97%. In response to these finding the CNS developed interventions for physicians, nursing staff and patients. The interventions included physician office documentation tools and educational brochures for physicians, nursing staff and patients. Teaching packets and educational modules were developed for staff nurses and diabetes educators. The interventions were implemented over a six month period of time. A follow up chart audit, including physician and hospital records, was conducted at six months. Positive clinical/financial outcomes were found. The findings demonstrated an increase in documentation of key clinical recommendations for care, decreased length of stay, meeting or exceeding national benchmarks and increased referrals to diabetes outpatient education/management program. Future considerations would include increased involvement of the staff nurse’s role in diabetes disease education/management. Research will need to be continued to document nursing outcomes across the continuum of care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleClinical Nurse Specialist Role in Development of a Disease Management Programen_GB
dc.identifier.urihttp://hdl.handle.net/10755/149387-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Clinical Nurse Specialist Role in Development of a Disease Management Program</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bandos, Jean</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Major Hospital</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jbandos@majorhospital.com</td></tr><tr><td colspan="2" class="item-abstract">A small community hospital identified the need for a diabetes disease management program to improve patient care and outcomes. The clinical nurse specialist was chosen to lead the initiative and develop an evidence-based practice model. The CNS role was to 1) analyze organizational structure and current processes related to diabetes education and management, 2) evaluate current patient outcomes and identify best practice models, 3) develop interventions based upon research and standards of care, and 4) create a multi-disciplinary chronic disease management program to be implemented across the continuum of care. The purpose of this presentation is to describe the clinical nurse specialist&rsquo;s influence in development of the diabetes disease management program. One goal of disease management is the patient&rsquo;s ability to access health care and to understand self care management skills. A sample of 800 patients with a diagnosis of diabetes was collected from claims data. A stratified random sample of 238 patients was selected. Insurance claims along with physician and hospital records were audited to identify the current level of diabetes disease management compared clinical practice recommendations published by the American Diabetes Association. The initial audit provided the CNS with baseline data to establish areas for improvement in the documentation of key clinical recommendations for care. The audit demonstrated a lack in documentation in the following areas: annual physician visit 32 %, blood glucose results 50%, HgA1C levels 61%, microalbumin levels 86%, and foot exams 97%. In response to these finding the CNS developed interventions for physicians, nursing staff and patients. The interventions included physician office documentation tools and educational brochures for physicians, nursing staff and patients. Teaching packets and educational modules were developed for staff nurses and diabetes educators. The interventions were implemented over a six month period of time. A follow up chart audit, including physician and hospital records, was conducted at six months. Positive clinical/financial outcomes were found. The findings demonstrated an increase in documentation of key clinical recommendations for care, decreased length of stay, meeting or exceeding national benchmarks and increased referrals to diabetes outpatient education/management program. Future considerations would include increased involvement of the staff nurse&rsquo;s role in diabetes disease education/management. Research will need to be continued to document nursing outcomes across the continuum of care.</td></tr></table>en_GB
dc.date.available2011-10-26T10:01:23Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:01:23Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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