case study format in community health nursing

Nursing Case Study Examples and Solutions

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NursingStudy.org is your ultimate resource for nursing case study examples and solutions. Whether you’re a nursing student, a seasoned nurse looking to enhance your skills, or a healthcare professional seeking in-depth case studies, our comprehensive collection has got you covered. Explore our extensive category of nursing case study examples and solutions to gain valuable insights, improve your critical thinking abilities, and enhance your overall clinical knowledge.

Comprehensive Nursing Case Studies

Discover a wide range of comprehensive nursing case study examples and solutions that cover various medical specialties and scenarios. These meticulously crafted case studies offer real-life patient scenarios, providing you with a deeper understanding of nursing practices and clinical decision-making processes. Each case study presents a unique set of challenges and opportunities for learning, making them an invaluable resource for nursing education and professional development.

• Nursing Case Study Analysis [10 Examples & How-To Guides] What is a case study analysis? A case study analysis is a detailed examination of a specific real-world situation or event. It is typically used in business or nursing school to help students learn how to analyze complex problems and make decisions based on limited information.
• State three nursing diagnoses using taxonomy of North American Nursing Diagnosis Association (NANDA) that are appropriate, formatted correctly, prioritized, and are based on the case study. NUR 403 Week 2 Individual Assignment Case Study comprises: Resources: The case study found on p. 131 in Nursing Theory and the Case Study Grid on the Materials page of the student website Complete the Case Study Grid. List five factors of patient history that demonstrates nursing needs. 
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Pediatric Nursing Case Studies

In this section, delve into the world of pediatric nursing through our engaging and informative case studies. Gain valuable insights into caring for infants, children, and adolescents, as you explore the complexities of pediatric healthcare. Our pediatric nursing case studies highlight common pediatric conditions, ethical dilemmas, and evidence-based interventions, enabling you to enhance your pediatric nursing skills and deliver optimal care to young patients.

• Case on Pediatrics : Part 1& 2 Solutions
• Pediatric Infant Reflux : History and Physical – Assignment 1 Solution
• Otitis Media Pediatrics Toddler – NSG 5441 Reflection Assignment/Discussion – Solution
• Pediatric Patient With Strep – NSG 5441 Reflection Assignment/Discussion
• Pediatric Urinary Tract infections (UTI) -NSG 5441 Reflection Assignment/Discussion – Solution
• Week 3 discussion-Practical Application in critical care/pediatrics
• Cough Assessmen t

Mental Health Nursing Case Study Examples 

Mental health nursing plays a crucial role in promoting emotional well-being and providing care for individuals with mental health conditions. Immerse yourself in our mental health nursing case studies, which encompass a wide range of psychiatric disorders, therapeutic approaches, and psychosocial interventions. These case studies offer a holistic view of mental health nursing, equipping you with the knowledge and skills to support individuals on their journey to recovery.

• Psychiatric Nursing: Roles and Importance in Providing Mental Health Care
• Mental Health Access and Gun Violence Prevention
• Fundamentals of neurotransmission as it relates to prescribing psychotropic medications for clients with acute and chronic mental health conditions – Unit 8 Discussion – Reflection
• Unit 7 Discussion- Complementary and Alternative Medicine in Mental Health Care – Solution
• Ethical and Legal Foundations of PMHNP Care Across the Lifespan Assignment – Analyze salient ethical and legal issues in psychiatric-mental health practice | Solution
• Pathways Mental Health Case Study – Review evaluation and management documentation for a patient and perform a crosswalk of codes – Solution
• Analyze salient ethical and legal issues in psychiatric-mental health practice
• SOAP notes for Mental Health Examples
• compare and contrast two mental health theories
•   Environmental Factors and Health Promotion Presentation: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants

Geriatric Nursing Case Studies

As the population ages, the demand for geriatric nursing expertise continues to rise. Our geriatric nursing case studies focus on the unique challenges faced by older adults, such as chronic illnesses, cognitive impairments, and end-of-life care. By exploring these case studies, you’ll develop a deeper understanding of geriatric nursing principles, evidence-based gerontological interventions, and strategies for promoting optimal health and well-being in older adults.

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• HE003: Delivery of Services – Emmanuel is 55-year-old man Case – With Solution The Extent of Evidence-Based Data for Proposed Interventions – Sample Assignment 1 Solution
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• Analysis of a Pertinent Healthcare Issue: Short Staffing
• Paraphrenia as a Side of the Schizophrenia – Week 4 Solution
• Module 6 Pharm Assignment: Special Populations
• Public Health Nursing Roles and Responsibilities in Disaster Response – Assignment 2 Solution
• Theory Guided Practice – Assignment 2 Solution
• How can healthcare facilities establish a culture of safety – Solution
• Discuss the types of consideration a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult – Solution
• Promoting And Protecting Vulnerable Populations – Describe what is meant by vulnerable populations and explain strategies you, as the public health nurse, could use to best facilitate the achievement of healthful outcomes in this population? 

Community Health Nursing Case Studies

Community health nursing plays a vital role in promoting health, preventing diseases, and advocating for underserved populations. Dive into our collection of community health nursing case studies, which explore diverse community settings, public health issues, and population-specific challenges. Through these case studies, you’ll gain insights into the role of community health nurses, interdisciplinary collaboration, health promotion strategies, and disease prevention initiatives.

• Community and Target Aggregate: Residents of the community health center, particularly those aged 65 and above Topic: Secondary Prevention/Screenings for a Vulnerable Population
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• Role of community health nursing and community partnerships as they apply to the participating family’s community – Assignment 1 Solution
• Community/Public Health Nursing DQ2
• CSU-Community healthcare Presentation – Assignment 1 Solution
• Community Healthcare Presentation – Domestic Violence And Level Of Prevention – Solution

Critical Care Nursing Case Study Examples 

Critical care nursing demands swift decision-making, advanced technical skills, and the ability to provide intensive care to acutely ill patients. Our critical care nursing case studies encompass a range of high-acuity scenarios, including trauma, cardiac emergencies, and respiratory distress. These case studies simulate the fast-paced critical care environment, enabling you to sharpen your critical thinking skills, enhance your clinical judgment, and deliver exceptional care to critically ill patients.

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Maternal and Child Health Nursing Case Study Examples

The field of maternal and child health nursing requires specialized knowledge and skills to support the health and well-being of women and children throughout their lifespan. Explore our collection of maternal and child health nursing case studies, which encompass prenatal care, labor and delivery, postpartum care, and pediatric nursing. These case studies provide a comprehensive view of maternal and child health, allowing you to develop expertise in this essential area of nursing practice.

You can also check out Patient Safety in High-Tech Settings PICOT Questions Examples

Surgical Nursing Case Studies

Surgical nursing involves caring for patients before, during, and after surgical procedures. Our surgical nursing case studies cover a wide range of surgical specialties, including orthopedics, cardiovascular, and gastrointestinal surgeries. Delve into these case studies to gain insights into preoperative assessment, perioperative management, and postoperative care. By examining real-life surgical scenarios, you’ll develop a comprehensive understanding of surgical nursing principles and refine your skills in providing exceptional care to surgical patients.

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Obstetric Nursing Case Study

Obstetric nursing focuses on providing care to women during pregnancy, childbirth, and the postpartum period. Our obstetric nursing case studies explore various aspects of prenatal care, labor and delivery, and postpartum recovery. Gain valuable knowledge about common obstetric complications, evidence-based interventions, and strategies for promoting maternal and fetal well-being. These case studies will enhance your obstetric nursing skills and prepare you to deliver compassionate and competent care to expectant mothers.

• Capstone Proposal: Postpartum Hemorrhage Education To Nursing Students
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• ADV HEALTH ASSESSMENT: TJ a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge – Solution
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• Three nursing diagnoses for this client based on the health history and screening (one actual nursing diagnosis, one wellness nursing diagnosis, and one “risk for” nursing diagnosis)
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Nursing Ethics Case Study

Ethical dilemmas are an inherent part of nursing practice. Our nursing ethics case studies shed light on complex ethical issues that nurses encounter in their daily work. Explore thought-provoking scenarios involving patient autonomy, confidentiality, end-of-life decisions, and resource allocation. By examining these case studies, you’ll develop a deeper understanding of ethical principles, ethical decision-making frameworks, and strategies for navigating ethical challenges in nursing practice.

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• Week 9 Assignment 9.1: Mercy Killing Ethics – Using one theory that you have studied that you agree with and one theory that you disagree with, describe how Officer Jones would act in each case – Solution
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Health Promotion Case Study

Community health promotion plays a crucial role in improving the health and well-being of populations. Our community health promotion case studies highlight successful initiatives aimed at preventing diseases, promoting healthy lifestyles, and addressing social determinants of health. Explore strategies for community engagement, health education, and collaborative interventions that make a positive impact on the well-being of individuals and communities.

• Health Promotion in Minority Populations
• Environmental Factors and Health Promotion Presentation: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants
• Health Education And Current Challenges For Family-Centered Health Promotion
• Cultural Competence And Nutrition In Health Promotion
• Why is the concept of family health important? Consider the various strategies for health promotion.
• levels of health promotion
• Integrate evidence from research and theory into discussions of practice competencies, health promotion and disease prevention strategies, quality improvement, and safety standards.
• Discuss various theories of health promotion, including Pender’s Health Promotion Model, the Health Belief Model, the Transtheoretical Theory, and the Theory of Reasoned Action.
• What strategies, besides the use of learning styles, can a nurse educator consider when developing tailored individual care plans, or for educational programs in health promotion?
• Describe health promotion for Pregnant women
• Identify a health problem or need for health promotion for a particular stage in the life span of a population from a specific culture in your area. Choose one of the Leading Health Indicators (LHI) priorities from Healthy People 2020: https://www.healthypeople.gov/2020/Leading-Health-Indicators
•   A description of a borrowed theory (expectancy-value theory and social cognitive theory) that could be applied to improve health promotion patient education in primary care clinic. Is this borrowed theory appropriate?
• How has health promotion changed over time
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Nursing Leadership Case Studies

Nursing leadership is essential for driving positive change and ensuring high-quality patient care. Our nursing leadership case studies examine effective leadership strategies, change management initiatives, and interprofessional collaboration in healthcare settings. Gain insights into the qualities of successful nurse leaders, explore innovative approaches to leadership, and learn how to inspire and motivate your team to achieve excellence in nursing practice.

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• The purpose of this assignment is to examine the impact of contemporary challenges in care delivery facing nursing leadership. Select and research a major issue in the delivery of care facing nurse leaders today and write a 1,250-1,500 word paper addressing the following:
• One nursing theory will be presented as a framework to resolve a problem occurring within one of the professional areas of leadership, education, informatics, healthcare policy or advance clinical practice.  The same nursing theory selected in Assignment One may be used to resolve the identified problem. 
• Module 6: Change and Leadership in Nursing Education – Professional Development
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• Analyze one of the following concepts: “Advanced Practice Nursing,” “Leadership in Nursing Practice” or “Holistic Nursing Practice”
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At NursingStudy.org, we strive to provide you with a comprehensive collection of nursing case study examples and solutions that align with the best practices recommended by YOAST and RankMath. By exploring these diverse case studies, you’ll enhance your clinical knowledge, critical thinking abilities, and overall understanding of nursing practice. Take advantage of this valuable resource and elevate your nursing skills to new heights.

Remember, success in nursing begins with knowledge and continues with lifelong learning. Explore our nursing case study examples and solutions today and embark on a journey of professional growth and excellence.

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Case Studies in Public Health Nursing - Access Card, 1st Edition

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• NEW! More than 50 online, unfolding case studies bring community/public health nursing to life in order to help you understand how the role of the public health nurse fits into unique populations.
• NEW! Each case study is organized in a consistent format featuring objectives, unfolding case scenarios, gradable NCLEX®-style review questions, and open-ended critical thinking and discussion questions.
• NEW! Suggested readings from Elsevier community health textbooks (Nies, Stanhope, Edelman) are included so you can easily cross-reference relevant content.
• NEW! Answer guidelines are provided for all critical thinking and discussion questions.
• NEW! Helpful printed User’s Guide includes an overview of public health nursing, a full description of each case study, and instructions for using the product.
• NEW! A list of relevant Giddens concepts is provided for each case study.
• NEW! Each case study incorporates evidence-based practice and exemplifies public health nursing interventions from the Intervention Wheel .
• NEW! The Quad Council Coalition’s Community/Public Health Nursing Competencies provide the framework for the case studies, ensuring practice examples for each competency domain are included.

1. Upstream Thinking: Introduction to Community/Public Health Nursing 2. Determinants of Health 3. Culture of Health

Competencies for PHN Domain 1 – Analytic and Assessment Skills

4. Community Assessment Part 1: Shoe Leather/Windshield Survey and Key Informant Interview 5. Community Assessment Part 2: Using Data Sources 6. Individual Health Risk Assessment 7. Family Health Risk Assessment 8. Environmental Health Risk Assessment

Competencies for PHN Domain 2: Policy Development/Program Planning Skills

9. Policy Development to Protect Health: Local Community Level Policy 10. Policy Development to Protect Health: State Level Policy 11. Policy Development to Protect Health: National Level Policy 12. Program Planning 13. Disaster Planning & Management Part 1: Mitigation & Preparation 14. Disaster Planning & Management Part 2: Response & Recovery

Competencies for PHN Domain 3: Communication Skills

15. Health Literacy 16. Individual Health Promotion 17. Family Health Promotion 18. Community Health Promotion

Competencies for PHN Domain 4: Cultural Competence Skills

19. Advocating and Working with Diverse Populations 20. Targeted Health Information for At-Risk Populations 21. Evaluate Agency Practices and Policies for Cultural Competence

Competencies for PHN Domain 5: Community Dimensions of Practice

22. Task Force Development 23. Coalition Development 24. Navigating United States Health Care System

Competencies for PHN Domain 6: Public Health Science Skills

25. Disease Outbreak – Infectious Disease in a College Dorm 26. Disease Outbreak – Foodborne Illness 27. Disease Outbreak – Potential Epidemic 28. Disease Outbreak – Global Health Risk 29. Disease Outbreak – Emerging Disease 30. Community Based Participatory Research

Competencies for PHN Domain 7: Financial Planning and Management Skills

31. Board of Health Report 32. Proposal for Funding from External Source 33. Delivering Care within Budgetary Guidelines 34. Conflict Management

Competencies for PHN Domain 8: Leadership and Systems Thinking Skills

35. Adhering to Ethical Standards 36. Nurse Managed Centers 37. Quality Management and Improvement 38. Public Health Workforce

Vulnerable Populations

39. Populations Affected with Disabilities 40. Poverty and Homeless 41. Rural and Migrant Health 42. Substance Abuse 43. Violence & Human Abuse

A Day in the Life: Specialty Practice

44. Case Management 45. Faith Community Nursing 46. Forensic and Correctional Nursing 47. Genomics 48. Global Health 49. Home Health and Hospice 50. Occupational Health 51. School Nursing

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Community health and public health nurses: case study in times of covid-19.

1. Introduction

2. materials and methods, 2.1. study design, 2.2. setting, 2.3. selection criteria, 2.4. data collection, 2.5. data treatment and analysis, 2.6. ethical aspects, 3.1. the first category, 3.2. the second category, 3.3. the third category, 3.4. the fourth category, 3.5. the fifth category, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Cunha, C.; Henriques, A.; Costa, A. Community Health and Public Health Nurses: Case Study in Times of COVID-19. Sustainability 2021 , 13 , 11149. https://doi.org/10.3390/su132011149

Cunha C, Henriques A, Costa A. Community Health and Public Health Nurses: Case Study in Times of COVID-19. Sustainability . 2021; 13(20):11149. https://doi.org/10.3390/su132011149

Cunha, Carmen, Adriana Henriques, and Andreia Costa. 2021. "Community Health and Public Health Nurses: Case Study in Times of COVID-19" Sustainability 13, no. 20: 11149. https://doi.org/10.3390/su132011149

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Implementation of nursing case management to improve community access to care: A scoping review

Alenda dwiadila matra putra.

1 Department of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

Ayyu Sandhi

2 Department of Pediatrics and Maternity Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

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.

Data Sources

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.

Review Methods

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.

Access to health care is still a persistent challenge in the healthcare system around the world. Since the Alma Ata Declaration of 1978, 134 countries and 67 international organizations have committed to eliminating the barriers to universal health coverage (UHC), thus providing accessible health services for all populations (Pan American Health Organization, 2019 ). One dimension indicating the UHC is the proportion of people covered by the health system. Based on the report from the World Bank and World Health Organization (WHO), half of the global population could not obtain basic health services due to poor access (WHO, 2017 ). Access to health care is defined as reaching a health care service, provider, or institution to utilize appropriate services in proportion to their need for care (Levesque et al., 2013 ). It comprises three distinct components: 1) being able to gain entry into the healthcare system; 2) being able to locate provided health care services; and 3) being able to communicate with trusted health care providers (Agency for Healthcare Research and Quality, 2020 ). The commitment to accelerate the UHC should be accompanied by efforts to strengthen community-based health care services and maintain appropriate healthcare financing systems.

Case management is used as an approach to promote better coordination of health care services and enable broader access to all populations. This intervention helps optimization of available resources; enhances communication among health care providers, patients, and their families; and serves as patient advocates within the health care system (Fabbri et al., 2017 ). As the largest occupational group in the health sector (WHO, 2020 ), the nursing profession contributes to important roles in case management. Within nursing, a case manager is a nurse responsible for case finding, multidimensional assessment, care delivery, monitoring, and evaluation of health outcomes of a patient and their families (Bertuol et al., 2020 ). To deliver effective case management intervention, a nurse case manager should obtain clinical, managerial, and financial skills. In addition, not only should a nurse case manager be proficient in the health and well-being of individuals across the lifespan, but also adept in communication (with patients, families, and health care team) and the health care system (Fabbri et al., 2017 ).

Currently, nurse case managers work in multiple settings from hospitals, home health services, or patient homes (Armold, 2019 ). It has been known as one strategy to reduce health care costs (van Voorst & Arnold, 2020 ). There was strong evidence of using case management to significantly reduce the patients’ hospital use and improve their quality of life (Joo & Liu, 2017 ; van Voorst & Arnold, 2020 ). For individuals with chronic illnesses transitioning between hospitals and their communities, case management is often cited as an effective intervention to improve access to health care services (Joo & Liu, 2017 ). According to the Commission for Case Management Certification (CCMC) in the United States, on average, two-thirds of nurse case managers work within community settings (Armold, 2019 ). However, the majority of evidence focused on improving patients' and families' quality of life, cost-effectiveness, and reduced hospital readmission rates. Information about community-based case management implementation in relation to its impact on access to health care is limited.

This scoping review aimed to examine the components of nursing case management in improving access to care within community settings as well as the issues for future implications. Two research questions were formulated: 1) “What are the components of nursing case management interventions to necessarily improve access to health care?” and 2) “What are the issues faced by nursing professions in delivering case management interventions?” This study is expected to provide existing information on how nursing case management contributes to leaving no one behind in the health system.

As the topic of community-based case management’s impact on access to health care has not been comprehensively reviewed, this study employed a scoping approach to evidence synthesis from existing literature following the guidelines by Arksey and O'Malley ( 2005 ): 1) formulation of the research question(s), 2) identification of relevant studies, 3) study selection, 4) charting the data, and 5) collating, summarizing, and reporting the results. A scoping review does not usually apply critical appraisal for selected studies as it includes a wide spectrum of studies and aims to broadly sum up the research findings (Nam et al., 2015 ).

Search Methods

Five electronic databases (CINAHL, PubMed, Science Direct, Scopus, and Google Scholar) had been searched to retrieve relevant references. Keywords of ((community) AND ("case manage*")) AND (nurs*) AND (access) AND (care) were applied to identify original studies published between January 2010 and February 2021 with free full-text availability in English or Bahasa Indonesia.

Eligibility Criteria

References were included if those were original studies employing quantitative, qualitative, or mixed methods; involving nurses as one of the professions performing case management roles; providing “access to health care” as the main finding; and published in peer-reviewed journals. Conversely, studies were excluded if they did not describe case management intervention or roles of nurse case manager; only focused on other types of health workers (i.e., community health workers, traditional healers); and in the form of review, editorial, commentary, book, policy documents, or government document.

Initially, 505 references were identified, of which 35 were duplicates. Two authors then independently screened 470 studies by title and abstract. After screening by title and abstract, the full texts of 34 studies were assessed for eligibility. After screening the full text, 15 studies were excluded. Six studies employed study designs that did not fit into the inclusion criteria, five studies focused on other types of health workers, and four studies provided no explanation about community case managers. Nineteen studies were found to meet the aim of this scoping review ( Figure 1 ).

Flowchart of searching and screening strategy

Data Extraction

Narrative tables were used to chart, collate, and summarize selected studies. The data charting table was created to identify themes from research findings in accordance with the research questions and purpose (Tricco et al., 2016 ). The data extraction table was formulated to insert the following information from selected studies: author, publication date (year), sample, design, research objectives, and findings.

Data Analysis

Data analysis was conducted by two authors, who summarized the major findings from selected studies to draw themes and subthemes independently (Tricco et al., 2016 ). Next step, the authors merged the data analysis and performed joint analysis to determine the sub-themes of research questions.

Search Results

Table 1 presents the characteristics of selected studies after the final full-text assessment. The majority of studies are qualitative studies, while the remaining articles included quasi-experimental studies, analytical studies (cross-sectional, case study, and cohort study), mixed-method study, and a study utilizing grounded theory.

Characteristics of selected studies

Analytical Findings

As seen in Table 2 , five components of nursing case management interventions to improve access to health care were deduced, namely: 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. There were also three issues of nursing case management identified, namely: 1) regulation ambiguity, 2) high caseloads, and 3) lack of continuing case management training. Table 3 presents a detailed summary of the final studies selected.

Themes and subthemes derived from the selected studies

Detailed summary of the final studies selected

Bridging Health Systems Into Community

Nurse case managers should be able to engage clients and their families in the health system. This was the most common role, as mentioned in the 16 studies. Nurse case managers are responsible for interpreting the information from the health system to clients and vice versa (Balard et al., 2016 ). In one case, a nurse case manager becomes the only health worker in the designated area; thus, it is important to obtain community trust (Setiawan & Dawson, 2018 ) so that initial treatment could be promptly delivered (Setiawan et al., 2016 ). Service provided towards clients and family members from the vulnerable population would eventually help reduce delays in receiving medical care (Setiawan et al., 2016 ; Tønnessen et al., 2017 ). To ensure the continuity of this role, a nurse case manager should possess strong collaboration skills with other health professions (Borgès Da Silva et al., 2018 ; Uittenbroek et al., 2018 ; Klein & Evans-Agnew, 2019 ). Shared care could be in the form of communicating with family physicians or arranging schedules with general physicians, referrals, or other community health resources (Hensley, 2011 ; Williams et al., 2011 ; Hudon et al., 2015 ; Klein & Evans-Agnew, 2019 ).

Providing the Process of Care

As many as 13 studies emphasize the importance of a nurse case manager in providing the process of care. The care process includes five essential steps: assessment, problem analysis, planning, implementation, and evaluation (Hudon et al., 2015 ; Klein & Evans-Agnew, 2019 ; Toney-Butler & Thayer, 2020 ). Following those steps, a nurse case manager should determine the formulation of a care plan to meet clients’ needs (Head et al., 2010 ; Brown et al., 2011 ; Manthorpe et al., 2012 ; Gage et al., 2013 ; Balard et al., 2016 ; Dhingra et al., 2016 ; Borgès Da Silva et al., 2018 ; Chapman et al., 2018 ; David et al., 2019 ; Cicutto et al., 2020 ). The care plan should be shifted from traditionally task-oriented to person-centered care (Uittenbroek et al., 2018 ) and involve family members to maintain the continuity of care.

Delivering Individually-Tailored Health Promotion and Prevention

Six studies reported that nurse case managers provided personalized health promotion and disease prevention along with case management itself. The development of personalized service plans helped the patients and families understand where they were leading (Hudon et al., 2015 ). Furthermore, it indicated that nurse case managers prepare different approaches to each patients’ condition so that the health information obtained would be completely in accordance with the patients’ needs. For example, Cicutto et al. ( 2020 ) presented that the nurse case managers catered face-to-face visits to teach asthma management (asthma control, inhaler utilization technique) for children diagnosed with asthma, and Brown et al. ( 2011 ) provided additional information besides regular diabetes self-management education sessions. Moreover, Uittenbroek et al. ( 2018 ) showed flexible and creative personalities were needed in terms of giving chronic care health education for the elderly into their daily routine. In general, a nurse case manager should perform promotive and preventive care to empower clients to be aware of lifestyle that might cause disturbance in health (Chapman et al., 2018 ; Uittenbroek et al., 2018 ); the goal is not only to improve patients’ understanding about one’s health but also to change their health-seeking behavior (Setiawan et al., 2016 ).

Providing Assistance in Decision Making

Five studies reported the nurse case manager’s role in assisting patients and their families in making decisions regarding the treatment and health status. Patients who had easy access to nurse case managers were reported to have better communication with health professions, better participation in the process of improving their health and well-being, and better healthcare transition (Hensley, 2011 ; Hudon et al., 2015 ). To be able to do that, a nurse case manager should own the leadership, articulation, and mediation skills (David et al., 2019 ).

Providing Holistic Support

Seven studies reported that the nurse case manager contributed to provide holistic support towards patients and their families. As mentioned in one study focusing on the elderly, patients, and their families emphasized that nurse case manager’s clinical expertise and psychological support contributed to the improvement of the continuum of care provided (Manthorpe et al., 2012 ). In another study, elderly and caregivers saw a case manager as a person to be “present”, “help others”, “respond to all the questions”, and to be “aware of everything”; thus, it is important for a case manager to show caring behaviors (Balard et al., 2016 ). A nurse case manager should also be aware of any cultural or environmental barriers that might hamper one’s health status (Brown et al., 2011 ).

Issues of Nursing Case Management

Three sub-themes of issues of nursing case management were identified. First, the regulation ambiguity issue was raised in terms of the roles and legal aspects. In one study conducted in Indonesia, the legal aspect for prescribing becomes an issue since nurses are not allowed to prescribe medication, yet sometimes they are the only health provider in the rural areas (Setiawan & Dawson, 2018 ). In Australia, they consistently agreed that gatekeeper and direct service provision were not the case manager roles. This study suggests that case managers should just coordinate care service and plan (You et al., 2016 ). In Norway, case managers often found that balancing their roles as a care-manager and a provider was a challenging task, also to set the limits between being private and professional and consider between patients’ needs and limited resources grant (Tønnessen et al., 2017 ).

The second issue of nursing case management is about the high caseloads; as mentioned in one study, a nurse case manager should perform multiple roles, thus working overtime (Klein & Evans-Agnew, 2019 ). The third issue in nursing case management is the lack of continuing case management training. Experienced nurses should serve as expert role models and consultants to the case management staff and help to develop training curriculum for case managers (Head et al., 2010 ). It is also mentioned that the understanding and recognition of a nurse case manager might depend on one’s adequate training, although, so far, there is no consensual model of course or training for nurse case managers (David et al., 2019 ).

This study provided evidence on components of community-based nursing case management and related issues within the last ten years. To the best of our knowledge, this is the first scoping review to describe the components and issues in the implementation of case management in improving community access to care.

This study discovered that nurse case managers connect, coordinate, collaborate, and care for the patients/community with health care service providers through holistic and personalized care provision. Also, it revealed that most of the nursing case management models cater to specific targeted populations. For example, elderly (Manthorpe et al., 2012 ; Gage et al., 2013 ; Balard et al., 2016 ; You et al., 2016 ), patients with long-term illness (Hudon et al., 2015 ; Uittenbroek et al., 2018 ), palliative patients (Head et al., 2010 ; Dhingra et al., 2016 ), students/children (Setiawan et al., 2016 ; Setiawan & Dawson, 2018 ; Klein & Evans-Agnew, 2019 ; Cicutto et al., 2020 ) and people living with mental health problems (Chapman et al., 2018 ) are the populations reported as the beneficiaries in this study. In one study conducted in Norway, Tønnessen et al. ( 2017 ) displayed nurse case managers as health providers to serve diverse populations with varied health conditions. Nurse case managers also play the same role towards adults under certain primary health care, as presented in a Canadian study (Borgès Da Silva et al., 2018 ). This finding showed that nursing case management could be implemented in bridging a broad range of cases and ages to improve access to care in various populations.

Another highlighted finding of this review was related to the issues that occurred during the implementation of nursing case management in the community settings. Case managers struggle with the ambiguity of the nurse case managers’ roles and deal with high caseloads as well as limited case management training. A study by Joo and Huber ( 2014 ), which reviewed nursing case management, also reported unclear and confusing roles for nurse case managers in the United States. Periodically nurse case managers wished to set clear boundaries, but due to the patient’s condition, nurse case managers were still required to provide direct care. It shows that the sense of caring remains a principle among nurse case managers. Advance training would be required for case managers to equip themselves in dealing with these issues (Machini et al., 2020 ; Muscat, 2020 ).

This review found the implementations of community-based case management are different according to each country’s health care system requirements. Developed countries like Australia, Norway, and Spain clearly divided the roles and responsibilities between nurses and nurse case managers. Case managers are only expected to perform their natural roles of the case manager. On the other hand, several countries' nurse case managers are also counted on to provide direct care services to the community besides performing their role as case managers. For example, in England, nurses can hold their role as case managers while simultaneously working as practice nurses in the clinic (Iliffe et al., 2011 ), as district nurses providing visits towards housebound clients in the community (Challis et al., 2011 ), and as disease-specific nurses in either secondary care settings or the community (Whittingham & Pearce, 2011 ). Also, in Indonesia, nurse case managers could be the only health professional in the particular area, so one should be familiar with disease management and treatments. Differences in roles of nurse case managers among countries are seen as the result of different health system issues and challenges in each nation.

There is a limitation to this scoping review. The terminology of community nursing management may vary among countries. As a result, it is plausible that several essential articles might not be included in this study. Therefore, future review studies should include more terminologies for the keywords in literature searching.

Implications for Nursing Management and Health Policy

In the era of UHC reform, many countries committed to provide accessible health services for all populations despite the consequences of high spending. This commitment should be accompanied by efforts in strengthening the community-based health care services. This study showed that nurse case managers improve the access of care for different populations in the community in both urban and rural areas. Besides, previous studies have provided evidence on the implementation of case management to reduce health care spending and the number of readmissions or rehospitalization (Joo, 2014 ; Duarte-Climents et al., 2019 ). This is the starting point for the government to incorporate the implementation of community-based nursing case management into the policy level. In addition, the government still has to consider the needs and challenges in determining which case management model is most suitable to the population.

Care coordination and care planning were the most components of nursing case management frequently associated with access to care. This scoping review showed that nurse case managers improve the access of care for different populations in the community, both urban and rural areas, besides reducing health care spending and the number of readmissions or rehospitalization. However, the initiation of implementation still has to consider the issues, needs, and challenges of each country in determining which case management model is most suitable to the population. Also, clear regulation and continuing training for case management should be provided by the authorities to reduce the occurrence of possible constraints during the implementation. Further research is needed to find a nursing case management model according to primary health care to accelerate achieving UHC and develop validated measurement tools to measure access to care based on the components of the community nursing case management model.

Declaration of Conflicting Interest

The authors have no conflict of interest to declare.

This study did not obtain any grant from a funding agency.

Authors’ Contribution

All authors contributed equally to the study conceptualization, methodology, article search, data analysis, writing, and editing of the manuscript. All authors approved the final version of the article.

Authors’ Biographies

Alenda Dwiadila Matra Putra, RN is an Assistant for Publication, Research, and Collaboration at the Department of Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia.

Ayyu Sandhi, RN, MSc is a Lecturer at the Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia.

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Community health nurses in action: a case study from Jordan

Affiliation.

• 1 School of Nursing, The Hashemite University, Zarqa, Jordan. [email protected]
• PMID: 17492996
• DOI: 10.1111/j.1466-7657.2007.00542.x

Community health nurses can make a considerable difference in the lives of disadvantaged population groups. One of their major roles is to conduct studies that focus on at-risk populations and to use the findings to implement nursing actions to promote the public's health. This case study describes one such activity in Jordan.

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