Quality

Journal of Nursing Scholarship
"Nurse Care Coordination in Community-Based Long-Term Care"

Nurse care coordination -- using a registered nurse who provides home care services through a state program and Medicare -- can improve the outcomes for both acutely and chronically ill elderly patients. The practice particularly leads to improvement in pain management, breathing difficulties and daily living activities.

Researchers evaluated 55 patients who received care through the Missouri Care Options program and received nurse care coordination, and 30 patients who received MCO care alone. The evaluations occurred at six and 12 months.

The study examined several measures of care, including incontinence, pain, breathing difficulties, depression and daily living activities. The study found that after a year, the group receiving NCC had better clinical outcomes; no significant difference was found at six months.

The study concluded that NCC should be used in patients requiring home care, particularly very frail patients. The researchers suggest that NCC provides patients with a better evaluation of their needs and that NCC programs improve the continuity of care for patients.

Some states are creating such programs to coordinate with Medicare and Medicaid services. Researchers note that, given the large amount of funding dedicated to health care, data should be collected to determine the forms of care delivery that result in the best patient outcomes.

The study was conducted by researchers from:

• The University of Wisconsin-Milwaukee;
  
• Boone Hospital Center in Columbia, Mo.;
  
• The Office of Medical Research, School of Medicine; and
  
• The University of Missouri-Columbia (Dorman Marek et al., Journal of Nursing Scholarship, Q1 2006).