School Nurse Case
Management:
The Importance of
Process and Outcomes
Maria M. Bonaiuto,
RN,MSN,NCSN
Mecklenburg County Health Department
249 Billingsley Road
Charlotte, NC 28211
[email protected]
704-336-4707
School Nurse Panel
Mary Cappleman, RN, MPH, NCSN
Glenna Cook, RN, MPH
Dixie Furr RN, BSN, NCSN
Denise McIlwain, RN, BSN
2
Lillian Wald
1867-1940
3
Mecklenburg County School
Nurses:
Our Place in History
4
Who Should be Case Managed?
Students who have:
 Multiple complex interactions with the nurse
 Chronic health conditions (poorly controlled)
 Academic concerns, with a health component
 Health or behavior issues that impede
learning
 Multiple absences
 A goal for improving health or other related
criteria that effect learning
5
Improved Quality of Life….what is it ?
 Increased
participation in activities, sports
 Improved nutrition, healthy weight
 Improved relationships, acceptance by
others
 Decreased anxiety, depression
 Decreased tobacco use, substance use
 Decreased risk taking behaviors
 Self report of increased well being
 Improved score on a formal Q of L Tool
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Steps to Case Management
 Select
students, using established
criteria
 Set goals with student, family, school,
provider (SMART goals)
 Document baseline
 Identify strengths, needs, stakeholders,
and resources
 Implement strategies
 Monitor, evaluate, repeat
 Document outcomes
 Celebrate!!!
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SMART Goals
 Specific
 Measurable
 Attainable
 Realistic
 Time
related
8
Documentation of Outcomes
Part of the Individual Student Health Record
Outcomes
Before CM
After CM
Improved
Yes / No
Attendance
Behavior
Grades
Health Compliance
Quality of Life
Goal in one or more areas:
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Outcomes of Nursing Case Management
School Year
‘02-03
‘03-04
’04-05
‘05-’06
‘06-’07
# of Students Case Managed
240
320
685
1,625
1,554
Improved Attendance
34%
29%
31%
26%
33%
Improved Behavior
27%
21%
21%
26%
31%
Improved Academic
Performance
29%
19%
29%
27%
28%
Improved Quality of Life
59%
54%
60%
64%
81%
Improved in health/health
Compliance
63%
No data
69%
66%
79%
Improved
In one or more areas
92%
74%
84%
84%
94%
10
School Nurse Case Management
and YOU
11
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School Nurse Case Management - Charlotte