Putra Alenda Dwiadila Matra, Sandhi Ayyu
Department of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Pediatrics and Maternity Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Belitung Nurs J. 2021 Jun 28;7(3):141-150. doi: 10.33546/bnj.1449. eCollection 2021.
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.
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.
This study was conducted following the framework of scoping review.
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.
The article screening was guided by a PRISMA flowchart. Extraction was performed on Google Sheet, and synthesis was conducted from the extraction result.
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.
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.
病例管理是一种用于帮助患者查找和管理医疗资源，以及加强患者、家庭和医疗系统之间有效沟通的方法。护士作为病例管理者的角色已被证明在降低慢性病患者的医疗成本方面是有效的。然而，对于其在改善社区环境中获得医疗服务方面的实施情况却知之甚少。
本范围综述旨在研究护理病例管理在改善社区环境中获得医疗服务方面的组成部分，并确定社区护理病例管理的问题，以供未来参考。
本研究遵循范围综述的框架进行。
作者系统地检索了五个电子数据库（CINAHL、PubMed、ScienceDirect、Scopus和谷歌学术），以查找2010年1月至2021年2月发表的相关研究。仅纳入了以护士作为在社区环境中履行病例管理职责的专业之一、并将“获得医疗服务”作为研究结果的原创研究。
文章筛选以PRISMA流程图为指导。在谷歌表格上进行提取，并根据提取结果进行综合分析。
共纳入19项研究。确定了护理病例管理在改善获得医疗服务方面的五个组成部分：1）将医疗系统与社区连接起来；2）提供护理过程；3）提供个性化的健康促进和预防服务；4）在决策方面提供协助；5）提供全面支持。此外，还确定了护理病例管理的三个问题：1）监管模糊；2）工作量大；3）缺乏持续的病例管理培训。
护理协调和护理计划是与获得医疗服务相关的护理病例管理中最常见的组成部分。这些发现对于提高护士执行护理程序的能力以及增强护士未来的倡导能力具有重要意义。
