NUR 590: Benchmark Evidence-Based Practice Project Literature Review Paper

NUR 590: Benchmark Evidence-Based Practice Project Literature Review Paper

NUR 590: Benchmark Evidence-Based Practice Project Literature Review Paper

Vulnerability, prevalence, and the interventions that people use to prevent and treat diseases vary profoundly across the globe. The impacts also differ depending on social determinants of health, among other factors. The World Health Organization reported that 38 million people worldwide die of chronic diseases that make up seven of the top ten causes of death worldwide (Joo & Huber, 2019). Chronic diseases have far-reaching effects since they increase emergency department visits, unplanned admissions and readmissions, and extended hospital stays. In response, case management has been suggested as a suitable solution to overcome the impacts of chronic diseases. Through case management, health care professionals and patients create a provider-client relationship and family members involved in care for the patients are included in a value-based environment (Marcotte & Liao, 2020). The purpose of this paper is to review the literature on the effectiveness of case management over traditional discharge planning.

PICOT: In adult patients with chronic diseases (P) does the implementation of  case management (CM) (I) in comparison to traditional discharge planning (C) help reduce length of stay, emergency visits, and readmissions (O) over the course of 6-12 months (T)?

Search Methods

Evidence search is intensive, and health care professionals must use current and scientific articles to support their proposed interventions. The entire search process started with identifying relevant databases for peer-reviewed health care and nursing articles, including PubMed, Medline, CINAHL, Embase, and the Cochrane Library. Google Scholar was also used partially. Next, search terms and phrases were constructed using appropriate combinations and Boolean operators. The articles were further filtered using the publication date (2018-2022) to ensure all were published in the last five years. Systematic reviews were excluded since they did not meet the required criteria.

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Synthesis of Literature

The first article for review was by Kim and Lee (2020) on whether case management reduces health care utilization. Subjects included 1741 case management clients who helped the researchers to evaluate the impact of community-based case management in reducing health care utilization and costs. Kim and Lee (2020) categorized the subjects into target groups receiving individualized services according to their characteristics. The key finding was that case management improves self-care ability and effectively reduces health care utilization and costs. The article supports the PICOT by underscoring the importance of case management in reducing health care utilization, which reduces hospital visits.

In another study, McCants et al. (2019) conducted a retrospective, descriptive, comparative analysis to determine the impact of case management versus usual treatment for patients with diabetes concomitant heart failure. Sixty-eight patients were enrolled, and medical chart reviews were conducted to collect and analyze data. McCants et al. (2019) found that case management significantly reduced readmissions (18.4% for patients undergoing case management versus 81.6% for patients in the usual care group. The article expands the PICOT by confirming the effectiveness of case management in reducing readmission, a key study element of the current study.

Grover et al. (2018) examined how case management for the emergency department (ED) affects inpatient length of stay. The subjects included 158 patients in a 225-bed hospital in a suburban area. In this study, patients were enrolled in a case management program and data was compared before and after the program through a chart review. The key finding was a significant reduction in ED visits (49%), inpatient admissions (39%) and the length of stay by 178 days through case management. The article supports the PICOT by confirming the effectiveness of case management in reducing ED visits, length of stay, and readmissions.

In a different study, Hudon et al. (2018) conducted a mixed-methods study to evaluate the effects of VISAGES case management intervention on patients with chronic diseases and complex care needs. In this pragmatic randomized controlled trial, 126 patients were enrolled in the intervention group and 121 in the control group. Data were collected and analyzed through in-depth interviews, focus groups, and author discussions. Case management was found to be an effective approach for reducing patients’ psychological distress, which enhances recovery and reduces readmissions in patients with chronic illnesses. The article underlines the critical role of case management in patients’ self-management, comprehensive recovery, and reducing readmissions.

Mattei da Silva et al. (2020) examined the effectiveness of nursing case management in controlling blood pressure among adults. Hypertension is common in chronically ill patients. The subjects included 47 patients in the intervention group and 47 in the control group. Through a randomized controlled trial, patients were assessed at baseline and 6- and 12-month follow-ups. Case management helped to decrease blood pressure in the intervention group. Other significant outcomes included improved waist circumference and medication adherence. The article confirms the effectiveness of case management in chronic disease management.

Uittenbroek et al. (2018) explored case management experiences among district nurses and social workers. They aimed to evaluate whether care through case management improves health care professionals’ experiences. Eleven participants (6 district nurses and 5 social workers) engaged in this qualitative study. Data were collected via in-depth interviews and analyzed through qualitative content analysis. Uittenbroek et al. (2018) found that case management helped nurses focus more on patients’ health conditions and helped social workers address patients’ psychosocial problems. The article highlights the benefits of case management in promoting holistic care, which reduces readmissions and hospital stays.

La Regina et al. (2020) evaluated the contribution of case managers (community pharmacists) and pharmacy services in improving health outcomes among patients with type 2 diabetes mellitus (DM2). The subjects included 40 patients in a rural community pharmacy. Personal data were collected in an electronic form. La Regina et al. (2020) found that case management reduces waiting time and improves patients’ adherence to individual care plans. Like many other studies, the article confirms the beneficial effects of case management over traditional approaches in managing patients with chronic diseases.

The last article to review is on the effectiveness of telecare case management programs for homebound older adults during the COVID-19 pandemic. In this study, Wong et al. (2021) examined the effectiveness of telecare case management in homebound older adults. Sixty-eight older adults engaged were recruited in the randomized controlled trial. Data were collected before the intervention at screening and one week after the three-month program. The telecare group showed a huge difference in medication adherence and quality of life compared to the usual care group. The article confirms the effectiveness of case management in improving patient care outcomes, which is critically required in patients with chronic diseases.

Comparison of Articles

Overall, the articles explore the effectiveness of case management in patient care but differ in many other features. They confirm that case management can be used to improve health outcomes, such as reducing readmissions, hospital stays, and health costs. Regarding themes, there is a consensus about the effectiveness of case management for chronic disease management and enabling health care professionals to focus more on the patients. Dominant themes include chronic disease management, family engagement, and value-based care. The most visible differences are in the methods of study. Apart from La Regina et al. (2020) and Uittenbroke et al. (2018) studies (qualitative), the rest are quantitative studies, primarily randomized controlled trials. They compare outcome differences between intervention and usual care groups.

On conclusions, the authors recommend case management in chronic disease management to achieve outcomes such as reduced readmissions and hospital stays, improved adherence to medication, and low consumption of health care. Limitations include small samples in the Uittenbroek et al. (2018) study and the absence of a usual care group in the La Regina et al. (2020) study to compare findings. Such limitations affect the studies’ findings generalizability. There were no controversies observed since all studies confirm case management as an effective approach in chronic disease management. All intervention groups achieved better outcomes than usual care groups.

Suggestions for Future Research

Several gaps have been identified and can be the foundation of future research. One of the identified gaps is the difference between case management for patients admitted to hospitals and those recovering at home. In this case, the role of family involvement should be explicit. The other gap is whether there is any correlation between the length of a case management program and patient outcomes. Areas requiring further research include barriers to case management in health care facilities and perceptions of care providers and patients toward case management programs.

Conclusion

Health care professionals use different strategies to optimize patient care outcomes. Case management is an effective, patient-centered approach that promotes value-based care. The literature review confirms the effectiveness of case management in reducing waiting time, readmissions, and hospital stays. Case management also improves adherence to treatment and individual care plans, among other beneficial outcomes. As a result, health care professionals should consider utilizing case management for patients with chronic diseases to reduce the length of stay, emergency visits, and readmissions.

References

Grover, C. A., Sughair, J., Stoopes, S., Guillen, F., Tellez, L., Wilson, T. M., Gaccione, C., & Close, R. (2018). Case management reduces length of stay, charges, and testing in emergency department frequent users. The Western Journal of Emergency Medicine, 19(2), 238–244. https://doi.org/10.5811/westjem.2017.9.34710

Hudon, C., Chouinard, M. C., Dubois, M. F., Roberge, P., Loignon, C., Tchouaket, É., … & Bouliane, D. (2018). Case management in primary care for frequent users of health care services: A mixed methods study. The Annals of Family Medicine, 16(3), 232-239. https://doi.org/10.1370/afm.2233

Joo, J. Y., & Huber, D. L. (2019). Case Management Effectiveness on Health Care Utilization Outcomes: A Systematic Review of Reviews. Western journal of nursing research, 41(1), 111–133. https://doi.org/10.1177/0193945918762135

Kim, M. J., & Lee, E. (2020). How to reduce excessive use of the health care service in Medical Aid beneficiaries: Effectiveness of community-based case management. International Journal of Environmental Research and Public Health, 17(7), 2503. http://dx.doi.org/10.3390/ijerph17072503

La Regina, R., Pandolfi, D., Stabile, N., Beloni, L., Glisenti, F., Griggio, P., … & La Regina, G. (2020). A new case manager for diabetic patients: A pilot observational study of the role of community pharmacists and pharmacy services in the case management of diabetic patients. Pharmacy, 8(4), 193. https://doi.org/10.3390/pharmacy8040193

Marcotte, L. M., & Liao, J. M. (2020). What we talk about when we talk about care management. The American journal of managed care, 26(6), 245–247. https://doi.org/10.37765/ajmc.2020.43486

Mattei da Silva, A. T., de Fátima Mantovani, M., Castanho Moreira, R., Perez Arthur, J., & Molina de Souza, R. (2020). Nursing case management for people with hypertension in primary health care: A randomized controlled trial. Research in Nursing & Health, 43(1), 68-78. https://doi.org/10.1002/nur.21994

McCants, K. M., Reid, K. B., Williams, I., Miller, D. E., Rubin, R., & Dutton, S. (2019). The impact of case management on reducing readmission for patients diagnosed with heart failure and diabetes. Professional Case Management, 24(4), 177-193. doi: 10.1097/NCM.0000000000000359

Uittenbroek, R. J., van der Mei, S. F., Slotman, K., Reijneveld, S. A., & Wynia, K. (2018). Experiences of case managers in providing person-centered and integrated care based on the Chronic Care Model: A qualitative study on embrace. PloS One, 13(11), e0207109. https://doi.org/10.1371/journal.pone.0207109

Wong, A. K. C., Wong, F. K. Y., Chow, K. K. S., Wong, S. M., & Lee, P. H. (2021). Effect of a telecare case management program for older adults who are homebound during the COVID-19 pandemic: A pilot randomized clinical trial. JAMA Network Open, 4(9), e2123453-e2123453. doi:10.1001/jamanetworkopen.2021.23453

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The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 “Evidence-Based Practice Project: Evaluation of Literature” assignment. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review in this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.

In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:

Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
Conclusion – Provide a summary statement of what you found in the literature.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.