Flying by the seat of their pants: A grounded theory of school nurse case management

Emotional Universe of Nurse Case Managers Regarding Care for Elderly at Risk in Spain: A Hermeneutical Study

The role of nurse case managers (NCM) involves a rarely visible emotional labor, even more when their role focuses on the care of elders at risk (EAR). Motivated by the lack of qualitative research on the emotional universe of NCM, this study explores the emotional universe (EU) of NCM regarding the care they provide to EAR in primary health care as well as the reasons that generate these emotions. An interpretative-phenomenological approach was implemented in southern Spain, with a purposive sampling that included nurses playing the NCM role for at least three years. Data collection was conducted in two periods (between September 2019 and July 2022). The primary collection tool was the semi-structured individual interview, with starting categories based on Bisquerra's EU taxonomy. The analysis followed Ricoeur's considerations, using the Nvivo software. In the NCM's EU, the recognition of the social phenomena stands out, with an open feeling of empathy regarding the desire of the EAR to continue living at home. However, there was also helplessness, resignation, disappointment, and frustration when EAR rejected their proposals. Furthermore, the system's limitations aroused compassion in the NCM and made them go beyond the limits of their role. This EU requires that their role be valued more, and higher responsiveness must be enforced to improve EAR care.

School Nurse-Parent Partnership in School Health Care for Children with Type 1 Diabetes: A Hybrid Method Concept Analysis

PURPOSE

To define school nurse-parent partnerships in school health care for children with type 1 diabetes (T1D) and determine its attributes using a hybrid model.

METHODS

This method involves a three-phase process: theoretical, fieldwork, and analytical. A literature review was conducted during the theoretical phase. A literature search of articles from January 1991 to February 2020 was conducted using relevant electronic databases. Eighty-three articles that met the inclusion criteria were completely read. Fieldwork data were collected through individual interviews from February to July 2019 in South Korea. In the fieldwork phase, interviews were conducted individually with 22 mothers of students with T1D and 20 school nurses recruited by purposeful sampling. Inductive content analysis was conducted. The findings from the theoretical phase were integrated with those from the fieldwork phase, and the final concept was derived.

RESULTS

School nurse-parent partnership in school health care for children with T1D has been defined as an interactive process of maintaining a balanced responsibility and providing tailored care to meet needs by establishing trusting relationships and communicating transparently and openly. This analysis yielded four attributes: trusting relationships, transparent and open communication, balanced responsibility, and providing tailored care to meet needs-this entails providing nursing actions by advocating for students and performing a negotiated role together or individually for student and family.

CONCLUSION

The findings of this study add to the importance of an attribute of balancing responsibility for partnership in school health care. The results show that this partnership could contribute to the development of a scale, theory, and nursing intervention in school health care for children with T1D.

School Nurses Matter: Relationship Between School Nurse Employment Policies and Chronic Health Condition Policies in U.S. School Districts

The increasing prevalence of chronic health conditions (CHCs) in school-aged children highlights the need to better understand school health services’ role regarding CHCs. Using U.S. nationally representative district-level data from the 2016 School Health Policies and Practices Study, we examined whether having policies on school nurses’ employment was associated with having policies on CHCs and whether having such policies varied by geographic location. Compared to districts without such employment policies, districts with such policies (52.3%) were significantly more likely to have CHC management policies. For each CHC policy examined, more than 20% of school districts did not have the CHC policy, with Northeast districts having the greatest proportion of such policies and West districts having the least. Thus, many students’ CHC needs may not be met at school. It is important for school nurses to play a key role in advocating for the development of school-based policies on CHCs.

What school nurses strive to achieve for themselves in order to remain in practice: A qualitative study

AIM

This study aims to describe and interpret what it is school nurses strive to achieve for themselves in order to remain in practice.

DESIGN

A qualitative study with a hermeneutic approach.

METHOD

The data were collected by means of in-depth interviews with 15 Norwegian school nurses on two separate occasions and analysed using a phenomenological hermeneutic method.

RESULTS

The analysis resulted in the following themes: (1) trusting your own professional ability, (2) aspiring to appreciation and (3) accomplishing self-care. These themes were reflected in the school nurses' choices and actions and were regarded as an expression of what was of value to them as a nurse. Thus, the nurses' realizing what they strived to achieve for themselves can comprehensively be understood as a good of higher value for their remaining in nursing practice.

An Evaluation of the Use and Effectiveness of Case Management in Clinical Nursing Education

Background

This study aims to evaluate the use and effectiveness of case management in clinical nursing education.

Methods

A sample of 181 nurses at the N3–N5 level were selected for clinical nursing education and divided into two groups using the random number method. The control group (n = 90) received traditional training, and the observation group (n = 91) received a case management model of training. The theoretical knowledge, nursing skills, training satisfaction, job stress, workplace mindfulness, career satisfaction, and job happiness of the two groups were compared. In addition, 50 patients were selected as subjects for each group, and their satisfaction with the nursing care that they received was also measured and compared.

Results

Theoretical knowledge and nursing skills scored higher in the observation group than in the control group (p < 0.05), and overall training satisfaction was higher in the observation group than in the control group (p < 0.05). After training, job stress in the observation group was lower than in the control group (p < 0.05), while workplace mindfulness, career satisfaction, and job happiness were higher in the observation group than in the control group (p < 0.05). In terms of nursing quality, on all indicators, the observation group scored higher than the control group (p < 0.05), and the patients’ nursing satisfaction scores were higher in the observation group than in the control group (p < 0.05).

Conclusion

Case management can improve the professionalism and overall skills of nurses at the N3–N5 levels. It is conducive to reducing job stress, enhancing workplace mindfulness, improving career satisfaction and job happiness, and improving the quality of nursing, thereby providing patients with better nursing care.

Implementation of nursing case management to improve community access to care: A scoping review

Background

Case management is an approach used to help patients locate and manage health resources as well as to enhance effective communication among patients, families, and health systems. Nurses' role as case managers has been proven effective in reducing healthcare costs among patients with chronic diseases. However, little is known about its implementation in improving access to care in community-based settings.

Objectives

This scoping review aimed to examine the components of nursing case management in improving access to care within community settings and to identify the issues of community-based nursing case management for future implications.

Design

This study was conducted following the framework of scoping review.

Data Sources

The authors systematically searched five electronic databases (CINAHL, PubMed, Science Direct, Scopus, and Google Scholar) for relevant studies published from January 2010 to February 2021. Only original studies involving nurses as one of the professions performing case management roles in the community-based settings, providing 'access to care' as the findings, were included.

Review Methods

The article screening was guided by a PRISMA flowchart. Extraction was performed on Google Sheet, and synthesis was conducted from the extraction result.

Results

A total of 19 studies were included. Five components of nursing case management to improve access to care were identified: 1) Bridging health systems into the community, 2) Providing the process of care, 3) Delivering individually-tailored health promotion and prevention, 4) Providing assistance in decision making, and 5) Providing holistic support. In addition, three issues of nursing case management were also identified: 1) Regulation ambiguity, 2) High caseloads, and 3) Lack of continuing case management training.

Conclusion

Care coordination and care planning were the most frequent components of nursing case management associated with access to care. These findings are substantial to improve nurses' ability in performing the nursing process as well as to intensify nurses' advocacy competence for future implications.

School nurses' perceptions regarding barriers and facilitators in caring for children with chronic diseases in school settings: A mixed studies review

This study aimed to understand school nurses' perceptions regarding barriers to and facilitators for health care services for children with chronic diseases in school settings. Using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Web of Science databases, a mixed studies review was conducted for literature published between January 2011 and June 2020. We performed a mixed-methods systematic review using a convergent integrated approach. A quality appraisal of the included studies was conducted using a mixed-methods appraisal tool. Twenty-seven articles (10 qualitative, 10 quantitative, and seven mixed-methods) that met the inclusion criteria were analyzed. Integrated findings that emerged from data synthesis were categorized into four levels (intrapersonal level, interpersonal level, institutional level, and community and public policy level) based on a socio-ecological model framework. This mixed systematic review provides a comprehensive understanding of school nurses' perceived barriers and facilitators when providing school health care for students with chronic diseases and how these barriers and facilitators interact across multiple systems. Further policies and strategies should be developed to provide effective school health services considering this study's findings.