MASTER RESOURCE OUTLINE

Credits: 3 (2 lecture; 1 R/D) 

Prerequisites: NRSG352and NRSG387R 

Course Description

This course focuses on themanagement of careacrossthe continuum with application of ethical and legal concepts.  Thenursing role in thecare management process will be explored.  Case management anddisease management willbe examined as methods ofmanaging health care. 

Course Objectives:The student will:  

  1. Discuss principles related to management of nursing care using examples from clinical experiences. (F12, T1-3, 8-9) 
  2. Compare and contrast care management, disease management and case management. (F12, T1-3, 8-9) 
  3. Discuss application of evidence-based practice to care management. (T4, 7) 
  4. Examine legal and ethical issues related to management of nursing practice. (T6-8, 11) 
  5. Demonstrate essential competencies of care management. (F10, T3, 7-9, 11) 
  6. Students will demonstrate behaviors that are congruent with the MSU Code of Conduct, CON Student Handbook, ANA Code of Ethics, Scope and Standards of Practice, and Social Policy Statements in all class related interactions. (F6-10, T2,3,5,6,11) 

Course Learning Outcomes

  1. Students will describe essential care coordination functions across the continuum of care.  
  2. Students will apply legal and ethical principles to discuss clinical scenarios.                                   
  3. Students will analyze healthcare settings related to structure, process and outcomes. 

Recommended Content and Concepts

  • Care management:   
    • History and contemporary models.  
  • Case management:   
    • History andContemporary Models; Definitions, Roles, Functions, Scope, and Goals of Case Management.
    • Screening,Assessment, Care Planning, Arranging For Services Delivery, Monitoring, Reassessment, Evaluation, Transitional Planning. 
    • Professional Values, Advocacy, Collaboration, Coordination, Delegation, Negotiation, Conflict Management, Decision-Making, Assertive Communication, Chain Of Command Communication. 
    • Quality Improvement, Variance Analysis, Critical Pathways, Care Maps, Client and Organizational Outcomes. 
    • Relationships Among Health Status, Utilization, Access, Quality, Outcomes, And Cost—How Care Management Can Affect These Relationships. 
    • Implementation of care management in various settings, e.g., public health, home health, acute hospital based care, mental health, managed care organizations, etc. 
    • Disease management, quality outcomes and appropriateness of care for client populations. 
    • Combining health promotion with illness management.  
  • Community resources 
    • Healthcare Spending; HealthcareReimbursement; Value-Based Payment Systems
    • Eligibility,Accessibility, and Appropriateness 
    • Interdisciplinary andInteragency Relationships  
  • Legal and ethical issues related to:
    • Nurse Practice Act 
    • Standards of Care 
    • Advanced Care Planning, withdrawing, withholding treatment 
    • Liability, malpractice, professionalnegligence 
    • Informed consent 
    • Disclosure 
    • Referrals 
    • Confidentiality and HIPAA 
    • Fraud and abuse  

Suggested Student Learning Activities

Student Presentations

Care Study/Clinical Pathways

Debate 

Discussion 

Role Playing

Video and Evaluation of Behaviors

Evaluation and/orDevelopment of Care Management Plans(e.g.,case management, disease management, outcomes management, critical pathways). 

 

Approved by UAAC: April 20, 2020  

Approved by Faculty: May 11, 2020