Nurse care coordination in community-based long-term care.
OBJECTIVE
To evaluate the clinical outcomes of a nurse care coordination program for people receiving services from a state-funded home and community-based waiver program called Missouri Care Options (MCO).


METHODS
A quasi-experimental design was used to compare 55 MCO clients who received nurse care coordination (NCC) and 30 clients who received MCO services but no nurse care coordination.


METHODS
Nurse care coordination consists of the assignment of a registered nurse who provides home care services for both the MCO program and Medicare home health services. Two standardized datasets, the Minimum Data Set (MDS) for resident care and planning and the Outcome Assessment Instrument and Data Set (OASIS) were collected at baseline, 6 months, and 12 months on both groups. Cognition was measured with the MDS Cognitive Performance Scale (CPS), activities of daily living (ADL) as the sum of five MDS ADL items, depression with the MDS-Depression Rating Scale, and incontinence and pressure ulcers with specific MDS items. Three OASIS items were used to measure pain, dyspnea, and medication management. The Cochran-Mantel-Haenszel (CMH) method was used to test the association between the NCC intervention and clinical outcomes.


RESULTS
At 12 months the NCC group scored significantly better statistically in the clinical outcomes of pain, dyspnea, and ADLs. No significant differences between groups were found in eight clinical outcome measures at 6 months.


CONCLUSIONS
Use of nurse care coordination for acute and chronic home care warrants further evaluation as a treatment approach for chronically ill older adults.
University of Wisconsin-Milwaukee, PO Box 413, WI 52301, USA. kmarek@uwm.edu
Karen Dorman
KD
Marek
Lori
L
Popejoy
Greg
G
Petroski
Marilyn
M
Rantz
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing; D003152:Community Health Nursing / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003863:Depression / Q000175:diagnosis; D004417:Dyspnea / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000458:organization & administration; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D008297:Male; D008923:Missouri; D009730:Nursing Assessment; D009733:Nursing Diagnosis; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis; D010347:Patient Care Planning / Q000458:organization & administration*; D015397:Program Evaluation