The Role of Nurse Case Managers in Preventing Readmissions for High-Risk Patients: Review

Abstract

Background: The rising prevalence of chronic illnesses and multimorbidity among patients necessitates innovative healthcare strategies to improve care coordination and prevent hospital readmissions. Nurse Case Managers (NCMs) play a pivotal role in addressing these challenges through comprehensive care management.

Methods: This review utilized electronic databases including PUBMED, SCIELO, SCOPUS, and DIALNET to analyze the literature on the effectiveness of NCM interventions in managing high-risk patients. Search terms included "nurse," "case management," and "chronic illness." A manual examination of references was conducted to identify additional relevant studies.

Results: The findings indicate that NCMs significantly enhance patient outcomes by providing holistic, patient-centered care. Interventions led by NCMs resulted in reduced readmissions, decreased emergency department visits, and improved self-management of chronic conditions. The NCM's approach fosters better communication among healthcare providers and encourages patient empowerment, leading to greater satisfaction and adherence to treatment plans.

Conclusion: The role of Nurse Case Managers is critical in the healthcare system, especially for patients with chronic illnesses. By improving care continuity and coordination, NCMs effectively reduce hospital readmissions and enhance the overall quality of care. Future research should focus on standardizing NCM practices and evaluating their long-term impact on healthcare systems and patient outcomes.