Standards of Practice for Nursing Case Managers
There are a lot of different professions in the world, and each of them has its own set of rules, traditions, and standards formed and polished in practice during the centuries. If speaking about nursing, it is maybe the most ancient kind of professional activity that has been gradually developing alongside with society and continues to change due to modern challenges. Changes that occur are related not only to the techniques or professional approaches but also new medical directions and care services. Thus, when relatively permanent medicine areas have sustainable standards of practice, case management that appeared not so long time ago is just in the process of standardizing. The paper seeks to explore the standards of case management practice as the modern challenging area of nursing, including those that already exist and tendencies caused by the urgent time challenges.
Before speaking about standards for case managers, it is worth to determine the essence of the notion that can provide the clear understanding of case management’s components and aspects lying on the basis of professional requirements to the nurses. Thus, case management is “the process of coordinating comprehensive services of health care that is aimed at achieving optimum quality of care in a cost-efficient manner” (AAOHN, 2013, p. 327). It serves as the link between the clients and those who provide care, including physicians, payers, and agencies. It is worth to admit that the more medicine becomes oriented on the smallest client’s needs, the more involved service appears in the system of case management. Thus, case management is not only nursing but also “interdisciplinary provider intervention” (Park & Huber, 2009, p. 175). Such interdisciplinary position of case management is the primary ground for creating distinct standards. Case managers should successfully operate the knowledge from the diverse professional area.
Based on the preceding information, case managers are the recognized experts and leading participants of the care coordination process. Apparently, substantial theoretical knowledge and skills based on professional experience that may be applied in practice are the minimal primary standard for nursing case managers. It is saying not only about the operating with basic nursing education but relevant modern information, including leading techniques and nearest tendencies. Institute of Medicine’s report about health system of the twenty-first century emphasizes that patients should be provided with “the care based on the best available scientific knowledge” (Lukinovich & Couvillon, 2010, p. 3). To follow this rule, nursing case managers should widely use evidence-based practice. Such practice implies their ability to correctly formulate the clinical question, collect the best relevant evidence, critically appraise them and integrate with clinical expertise, as well as adopt a professional decision and evaluate changes caused by it (Lukinovich & Couvillon, 2010).
Nursing implies quite close communication with clients during the most complicated periods of their life when non-professional approach may harm the humans’ feelings or dignity. Taking into account this fact, following the Code of Professional Conduct is the second crucial standard for nursing case managers. Besides basic communicative principles, nursing case managers should develop their mediation skills that can help them solve various ethical dilemmas and initiate and conduct crucial conversations (Smith, 2011). A case manager should be the person with a positive disposition who is able to build healthy relationships, is ready for negotiations, and owns risk arrangements in order to succeed in this task. Confidentiality and client privacy are among the primary standards of nursing in the ordinary practice as well as in the case management.
Cultural competency is one more communicational aspect that lies on the basis of practice’s standards for case managers, especially in the United States characterized by ethnic diversity of the population. Not knowing the core values of the ethnic group may lead to the unexpected communicational transgression and even to the applying of false care measures. It can obstruct the process of treatment and promote increasing of social tension. Thus, cultural competency is as significant for case managers as professional knowledge and crisis management skills.
The challenges of time transform case management into the unprecedented outcomes-centered sector, creating more complicated tasks for case managers (Daniels & Frater, 2011). Today, case management addresses human needs beginning from medical and psychosocial and ending with behavioral and spiritual ones. Intensive involvement of the patients or their caregivers in the process of making the medical decision is one of the brightest manifestations of this tendency.
The collaborative partnership approach is the latest standard of practice for case managers. It can help exclude the possibility of professional mistake from the practice. Moreover, it promotes broad applying of evidence-based practice that is the core standard of case management. Nowadays, standards of practice for case management include aspects influencing the current practice of case management that is predetermined by the health care environment existing today. Being closely related to the clients’ needs, these standards can be changed as soon as human priorities are shifted.
Nursing is the vital element of case management that gradually becomes the prevailing care model throughout the world, including the United States. Considering that case management is a relatively young direction, it still has no substantial theoretical basis. However, this fact does not undermine its role in the care system as well as being focused on the outcomes and clients’ needs. Nursing case management is sensitive to the challenges of time and modern tendencies. Accumulating the best multidisciplinary experience, it is unwillingly oriented to the high standards.
American Association of Occupational Health Nurses. (AAOHN) (2013). Case management: The occupational and environmental health nurse role. Workplace Health & Safety, 61(8), 327-328.
Daniels, S., & Frater, J. (2011). Hospital case management and progression of care. Healthcare Financial Management, 65(8), 108-113.
Lukinovich, L. A., & Couvillon, J. (2010). Evidence-based practice for the legal nurse consultant. Journal of Legal Nurse Consulting, 21(3), 3-7.
Park, E. J., & Huber, D. L. (2009). Case management workforce in the United States. Journal of Nursing Scholarship, 41(2), 175-183.
Smith, A. C. (2011). Role ambiguity and role conflict in nurse case managers. Professional case management, 16(4), 182-196.