[The implementation of nurse case manager's in wards for acute and post-acute patients: the perception of health care workers and patients and the impact an clinical outcomes].
Nurses case managers were implemented since 2000 in several wards of S. Orsola hospital in Bologna.


OBJECTIVE
The aim of this study is to assess the association of ICM to clinical outcomes and patients and nurses satisfaction.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Chiari
Paolo
P
Università di Bologna.
Sist
Luisa
L
Moranda
Dina
D
Biavati
Catia
C
Cormons
Viviana
V
Tietz
Catleen
C
Taddia
Patrizia
P
D000368:Aged; D001291:Attitude of Health Personnel; D019090:Case Management / Q000458:organization & administration / Q000639:trends*; D005260:Female; D006748:Hospital Departments / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D007558:Italy; D007588:Job Satisfaction; D007902:Length of Stay; D008297:Male; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000639:trends; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D000078329:Workforce