8.6 Resource Stewardship and Case Management
Resource Stewardship
Resource Stewardship is one of the Standards of Professional Performance established by the American Nursing Association (ANA). Resource stewardship is defined as using appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, financially responsible, and used judiciously. See the following box for competencies associated with the ANA’s Resource Stewardship Standard of Professional Performance.[1]
Competencies of ANA’s Resource Stewardship Standard of Professional Performance[2]
- Partners with the health care consumer and other stakeholders to identify care needs and necessary resources to achieve desired outcomes.
- Collaborates with the health care consumer and other stakeholders to assess costs, availability, risks, and benefits in decisions about care.
- Secures appropriate resources to address needs across the health care continuum.
- Advocates for equitable resources that support and enhance nursing practice and health outcomes.
- Integrates connected health technologies into practice to promote positive interactions between health care consumers and care providers.
- Uses organizational and community resources to implement interprofessional plans.
- Addresses discriminatory health care practices and the adverse impact on allocation of resources.
Case Management
Nurses are tasked with daily case management activities and allocating appropriate resources to their clients. Two common types of case management that staff nurses provide are educating clients about using appropriate levels of care and encouraging the use of cost-effective health care team members.
Several levels of care are available to clients for their health care services:
- Emergency department care has specialized providers and high-level diagnostics and should be reserved for immediate and potentially life-threatening needs.
- Urgent care is an elevated level of care above an outpatient visit, yet below the needs of an emergency visit. Nurses should refer clients to this setting if they have a health need that needs attention within the next 24 hours but is not life-threatening.
- Outpatient health settings provide health maintenance for chronic disease or treatment of nonurgent acute conditions. They also provide preventative services like well-baby checks and immunizations. In the outpatient setting, the nurse recognizes the client’s time with a provider is limited, so the majority of a nurse’s time is often spent providing client education, answering questions, and coordinating care.
- Inpatient and acute care typically occurs in a hospital setting where skilled nursing, diagnostic tests, and medical treatments are required. Nursing goals in these settings are to address immediate health concerns, stabilize the client, and prepare them for discharge. Most inpatient stays are 72 hours or less, so nurses must provide efficient care that includes adequate c