Practice Roles of Nurse Case Managers for Quality Improvement of Diabetic Patient Care in Health Region 10 Community Hospitals

Abstract

This descriptive research had two objectives. First, to study the practice roles of 92 Registered nurse case managers (RN-NCM) in relation to quality improvement in the care of diabetic patients. The participating RN-NCMs worked in diabetic clinic in the Outpatient Departments of 68 community hospitals under the 10^th Health region. Secondly, to compare the management practice roles between RN-NCMs receiving training in a 4-month program (Diabetes [DM] and Hypertension [HT] ) and RNs working in diabetic clinics. The study’s participants were divided into two groups with 46 patients in each. The participants were recruited based on the study’s inclusion criteria. Research instruments included a general information questionnaire and a questionnaire asking about management practice roles. The content validity od the mnagement practice role questionnare was asessed by five experts and a Content Validity Index (CVI) of 0.96 was achieved. Reliability was tested by analyzing the Cronbach's alpha coefficient, which was 0.94. Data were analyzed using descriptive statistics, frequencies, percentages, means, standard deviations, and independent t-tests.             

Results: The study showed that the RN-NCM (DM and HT) performed all the aspects of their practice roles at a high level (Mean = 3.83, S.D. = 0.53). Whereas, the RNs working in  the diabetes clinics only performed all the aspects of practice roles at a moderate level (Mean = 3.30, S.D.= 0.69). The RN-NCM (DM and HT) had a statistically significantly higher level of practice role performance than the RNs working in the diabetes clinics (t₉₀= 4.07, p<.001). Therefore, the RNs who care for diabetic patients should be RN-NCM (DM and HT) who taken the 4-month training program to gaining the knowledge and specialized skills required for diabetic care, which will result in more effective and efficient diabetic management outcomes.