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Nursing Specialties Part 2: Case Management, Certified Nurse Midwives, Diabetes Nurse Educators, Doctors of Nursing

Diabetes is now a global epidemic; it is the fourth or fifth leading cause of death in most developed and newly industrialized countries. RN Case Management Services will have accountability for a designated population defined in conjunction with the clinicians in the medical home, and assists the organization in meeting regulatory service and care needs for these populations. The audiovisual resource consists of two scenarios, the first demonstrating sub-optimal performance of the healthcare team, with the second demonstrating more effective performance, improving the patient experience. The RN Case Manager provides a variety of nursing services both in person, by phone and via electronic media utilizing nursing process and leadership skills to address acute and chronic needs of Health Plan members and other patients of the Kaiser Permanente Health Care Program. Nurse case managers, trained in clinical guidelines and brief behavior change counseling techniques (motivational interviewing), will aim to foster patient adherence in the experimental group patients. Essential Functions: • Utilize regional population stratification information and processes to identify appropriate members for enrollment into case management in collaboration with clinicians and health care team. • Independently and proactively complete chart reviews, screening calls and full assessments related to the anticipated level of care and document findings using standardized approved documentation tools.

– Triage findings from member assessments, identifying needs and issues, engage patients to define a plan of care and appropriate level of self management and interventions. A significant proportion also experienced social or mental health problems and improving self-management for this client group poses particular problems. The challenges of recruitment and retention of subjects in this study will also be discussed. Their roles and responsibilities include but are not limited to: multifaceted patient care that focuses on empowering patients and family members with the knowledge and skills to prevent and manage diabetes, demonstrate the usage of glucometers, insulin syringes, medication administration, dietary modifications, exercise routines, and evaluate effectiveness of care plans initiated. Doctors of Nursing Practice (DNP’s) are considered terminal degrees—the highest level of education a nurse can attain—and offers an opportunity to directly affect patients in a way alternative to the PhD degree which focuses more on nursing research. Also a DNP is a clinical practice focused doctorate instead of a research focused doctorate. Relevance to clinical practice.

MTM programs are developed in cooperation with licensed and practicing pharmacists and physicians, and are intended to reduce the risk of adverse events.2 Diabetes remains among the top targeted diseases for MTM initiatives. Family Nurse Practitioners (NP’s) are registered nurses who serve as primary and specialty health care providers. Much like a family doctor, Family Nurse Practitioners work with patients throughout their lives, diagnosing illness, conducting exams, and prescribing medications and treatments. NP’s can also serve as a patient’s sole health care provider and run their own private practices. Our nurses are trained to manage them with an insulin-glucose infusion protocol. Independent of any effect on blood pressure, treatment of microalbuminuria (incipient diabetic nephropathy) (24–29) and clinical proteinuria (overt diabetic nephropathy) (30) with ACE inhibitors slowed the progression of renal disease. We encourage you to get out there and learn more about the wonderful opportunities that specializing in nursing can offer for you and your patients.

Stay tuned for Part 3 where we will highlight five more wonderful nursing specialties.

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