The Responsibilities of the Nurse Case Manager

The following are the responsibilities for the nurse case managers. However, as a team any part of the clinical team can step in and assist when needed.

Process for established patients:

Using the “Medical History” sheet, anticipate what products will be needed during this visit. What instruments the physician may need, i.e. special sized curette, blade, scissors, pickups, graft supplies, or debrisoft, and what may be needed to position the patient (bolster, pillow, etc.) and what may be required to dress the wound. Collect these prior and have them in the room.

Assist patients to exam rooms

  • Position the patient appropriately in the exam chairs; keeping in mind what position is best for patient comfort and for the clinical team to be able to assess, debride, and dress the wound (save your back!)

Collect vitals and chart them in Azalea

While this is taking place, ask the patient pertinent questions about how their at home wound care has gone since their last visit: (These are just examples. Use clinical judgment. What is most important for the specific patient that you are working with at the time):

  • How was the week with the wound?
    • This can include, but is not limited to:amount, number of dressing changes performed, any increase in pain or swelling, changes in color around wound, increase/change in activity of the patient.
  • Have they received supplies, did they bring any with them, are they familiar with how to use them at home?
  • If we referred them to another practice (vascular, infectious disease, etc.), have they made an appointment or been seen?
  • If we ordered special items for the patient such as an offloading device, have they received it or been in contact with a representative from the company?
  • Any changes in the patient’s overall condition since last visit?
    • Other doctor’s visits
    • Any planned procedures
    • Any new medications

*If this is a new patient, simply add the following questions:

  • Do you have allergies?
  • Do we have a current medication list?
  • What is your preferred pharmacy?
  • Are you a diabetic? Do you know your last A1C?
  • Do you smoke? If you quit, how long ago did you quit, and for how long did you smoke?
  • Do you have circulatory issues?
  • How did you obtain the wound?
  • What treatments have you been applying to the wound?
  • What other doctors do you see? (primary care provider, vascular, podiatrist, etc.)
  • How did you find TenMed Wound Care Specialists?

*Use the “Medical History” sheet to write down any important points that you received from this conversation.

Assessment:

  • Take a quick overview of how the patient is presenting today and make note.
  • For patients with lower extremity wounds, ask the patient to remove both shoes and assess their feet and palpate pedal pulses.
  • Obtain calf measurements for lower extremity wounds and document them in the eKare notes section under the lowest numbered lower extremity wound (more on this in the “What to Chart and Where” section).
  • If it has been 6 months since their last ABI, obtain a new measurement when appropriate.
Job Category: NCM
Job Type: Part Time
Job Location: Sandy Springs

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