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 mbonaiuto@carolinas.org 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 6 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!!! 7 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: 9 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