Studio per documentare l’esperienza dell’inserimento degli infermieri case manager in reparti per acuti e post acuti: il punto di vista degli operatori, dei pazienti ed i risultati clinico-organizzativi

Abstract

Nurses case managers were implemented since 2000 in several wards of S. Orsola hospital in Bologna. The aim of this study is to assess the association of ICM to clinical outcomes and patients and nurses satisfaction. The mean hospital length of stay, the number of planned discharges and of falls were assessed the year before and after the implementation of case managers in 14 wards. Nurses satisfaction was assessed exploring in 13 wards the nurses, doctors and nurses aids' perception of positive changes and benefits after the implementation of case-managers and patients satisfaction (8 wards) with the Newcastle satisfaction with nursing scale. No differences were observed in mean length of stay, only a small increase of planned discharges (+8.2%) and a decrease (-24%) of patients falls. The questionnaire on perception of positive changes showed an higher satisfaction of nurse managers but an overall appreciation (agreement > 2.8 on a 4 points likert scale) for improvement on organization and patients management. The unaffected elements were perception of workload and stress. The patients' satisfaction with nursing care supported the nurses perception. The choice of indicators to document organizative changes is not simple. Positive effects were observed only on health care workers perception and on the decreased number of falls. Future studies are needed to confirm the positive trends observed.