F-2-05-03
CARDIOPULMONARY REHABILITATION: THE ROLE OF THE CLINICAL NURSE SPECIALIST
T. Hilton, B. Huiskes, Loma Linda University Medical Center Loma Linda, CA., USA
As the clinical nurse specialist (CNS) as an advanced practice nurse continues to grow, it is imperative the cardiopulmonary rehabilitation (CPR) CNS demonstrate their value added service. The incentive to focus on disease/illness prevention for these high cost patients is considered a crucial dimension for the success of the program. We will discuss how the specialist functions as a clinical expert, educator, researcher, consultant and program coordinator for the patient requiring CPR. We will present how the CNS's intervention in the home care outpatient setting prevents costly untoward costly outcomes and facilitates improved patient quality of life. We will present the case management approach and techniques for working with third party payers, data collection on clinical outcomes and disease management techniques. We will describe the CPR nurse's role as consultant and program coordinator for CHF, lung volume reduction and home mechanical ventilation. We report results of our clinical outcomes, cost effective programs and patient quality of life studies.
F-2-05-04
VENTILATOR ASSISTED PATIENT CASE MANAGEMENT MODELS AND OUTCOME STUDIES FROM THE ICU THROUGH HOME: THE ROLE OF THE REHABILITATION NURSE
T. Hilton, D. Valkuchak, Loma Linda University Medical Center Loma Linda CA. USA
Advances in technology has resulted in extending life for the catastrophically ill patient. Intensive care units are now faced with developing case management programs for these high risk/technology dependent high cost patient population. We will present how two case management models developed and successfully used for the ventilator assisted patient by the pulmonary rehabilitation nurse. The models represent 13 years of role development from the inception of home mechanical ventilation to current expert care at our tertiary care trauma center for the pediatric and adult patients. We will present outcome studies of ventilator assisted patients as it relates to cost effective care in multiple settings-ICU, basic care, subacute and home care. Ranges start in the ICU at $100,000./month to $3000.00/month for home care. Reasons for readmission to the acute care setting were primarily for non-respiratory medical/surgical problems as opposed to pneumonia. Quality of life in the home as defined by the patient were highly individual using these models of care.
