Questions and requirements analysis

Nurse Case Manager:

Case management in the nursing field is basically described as the functions and activities carried out by the nurse case manager within a specific care setting. In some cases, these functions and activities are usually performed by a self-governing practitioner, especially in private case management practices and community nursing facilities (Cohen & Cesta, 2005, p.278). Generally case management responsibilities are provided by the nurse case manager in acute care, primary care, home care, and managed care organizations. Nonetheless, these activities may be offered to particular patient populations and communities like the elderly. Some of the most case management activities include patient identification and intake, problem identification and assessment, patient outreach, development and implementation of plan of care, and coordination of care.

Roles and Functions of Nurse Case Manager:

In acute care organizations, the roles and functions of the nurse case manager includes coordinating the care provided to a group of patients. While this process is usually known as case mix or caseload, it usually starts during patient admission and goes beyond discharge. During this procedure, the nurse case manager applies the nursing process, which is assessment, diagnosis, planning, execution, and analysis. Secondly, the nurse case manager is responsible for ensuring the delivery of access to health care and the provision of cost-effective and outcome-centered quality care (Cohen & Cesta, 2005, p.279).

In primary care organizations, nurse case managers have the responsibility of ensuring that patients are effectively admitted and transitioned to the suitable level of care. These professionals also need to ensure that patients have an appropriate plan of care and undergoing prescribed treatment. The third role and function of nurse case managers in primary care settings is to ensure that patients have a campaigner for services and plans that are necessary during and after their stay in the health care facility.

However, in the home care settings, the roles and functions of nurse case managers extend beyond planning for care transitions, patient discharge, and after-discharge follow-up. In this case, these professionals coordinate with the patients, their families, sources of funds, and community resources. As they coordinate with agencies that provide necessary services, the nurse case managers ensure effective resource utilization in delivery of quality care.

Nurse Case Managers and Congestive Heart Failure:

Generally, heart failure cases are regarded as one of the most common and increasingly challenging diseases for nurses. Since the course of this disease is not usually fostered by patient education, the input of nursing in attempts to address the problem tends to be deceptively simple and straightforward (Blancett & Flarey, 2006, p.386). This is mainly because the staff nurses are mainly involved in the development and execution of treatment goals that are always difficult to achieve because of the complexity of treatment protocols, the need for knowledge and cooperation, and the need for active participation by patients.

While heart failure is also a challenge for case management, nurse care managers can play a critical role in coordinating suitable care for heart failure. The ability of case management to coordinate appropriate care in this incidents originate from the additional steps, considerations, and issues that nurse case managers address that would not be handled by staff nurses. Furthermore, these professionals interface with other members of the interdisciplinary health care team during the process.

These additional steps include overseeing treatment of heart failure through care paths that are adjusted based on the patient's living condition, culture, and resources. Secondly, the nurse case manager links the nursing interventions to the outcomes of the patient through changing resources to suit the specific profile and environment of the patient. Third, the nurse case manager is involved in analyzing the schedule of medication and holding discussions with the physician on streamlining the schedule. Notably, the major step taken by nurse case managers in dealing with heart failure cases is developing a heart failure care path or map that incorporates nursing diagnoses and representative outcomes (Blancett & Flarey, 2006, p.388). During this process, the nurse case manager interfaces with the physician, funding sources, and community resources to ensure the delivery of quality care through effective resource utilization.

Skills for Preparing Community Health Plan for a Patient:

As the nurse case manager is usually a social worker instead of a nurse, community health nurses usually have varying responsibilities since they work with a diverse range of people or groups. However, the community members usually want a health care system that responds to their needs. As a result, nurses require some essential skills that enable them to be better prepared to carry out a community health plan for a patient.