Case Management Role of the Agency RN

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Case ManagementRole of the Agency RN

• Kara Szirotnyak MSN,RN,COHN-S,NLC
• Workers Compensation Program Manager
• VISNs 11,19 23
• Department of Veterans Affairs

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Objectives

• Utilization of team process with
  interdisciplinary staff
• Develop implement effective limited duty
  programs
• Develop mentor/preceptor programs

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Responsibilities

• Case management for injuries begins at the time
  of the injury!!!!! And continues until the
  employee has returned to work and beyond..

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Goals of Case Management

• Ensure proper care and treatment of employee
• Ensure medical documentation is appropriate (does
  the diagnosis fit the claim)
• Monitor case progression
• Guide agency actions with DOL
• Assist employee with integration back into the
  work environment

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Goals (contd)

• Empower employee to make responsible decisions
  regarding their recovery
• Encourage the employee to maintain a lifestyle
  that will enhance their health and well being
• Maintain open lines of communications between all
  interdisciplinary services (DOL, primary care
  provider, rehab nurse, voc rehab, injured
  worker).

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Occupational Health Nurses Role

• Ensure expeditious, appropriate treatment
  immediately post injury

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Proactive Ergonomics

• Better to fix it now then later..utilize
• Interviews
• Analysis of work sites
• Surveys

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Reactive Ergonomics

• Post injury investigation
• Pre-return to limited duty
• Pre-return to normal duty

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Support

• Your agency MUST be in full support of the
  injury prevention team as well as the agency
  RN/OHN to have a successful program!!!

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Monitoring Strategies

• Compassion
• Communication
• Control
• Capabilities

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Compassion

• Listen to what they are saying
• Include them in decisions regarding their
  job/duties
• Include them in their plans of care
• Remember..injuries arent always visible!
• How would you want to be treated???

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Communications

• Maintain open lines of communication
• With employeecontact them for update on their
  care treatment
• With employees doctors/specialists
• With employees service/supervisor

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Control

• Team approachyou are an important part of the
  team!!!!
• Fit job to employee NOT employee to job
• Monitor employees integration back into the work
  force.
• Assess employees work area for ergonomic
  appropriateness

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Capabilities

• Focus on what they CAN do not on what they CANT
  do
• Utilize residual capabilities. There are very few
  individuals that are 100 disabled
• Functional Capacity Testing/Evaluation

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Employees Dont RTW Because??!!

• Fear of re-injury
• Fear of pain recurrence
• Anger at employer/supervisor
• GONE TOO LONG syndrome
• Utilizing OWCP for retirement program

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Best Intentions

• No matter what you dohow right you know you
  are.you may not achieve the desired
  results.Lesson learned.
• Know When To Fold Them!!!!