A nursing case management tool for occupational health nurses was described, with emphasis on development, testing, and application. Injury disability case management was discussed with particular reference to musculoskeletal injury disability and firefighter musculoskeletal injuries. A retrospective chart review was conducted on 61 firefighter musculoskeletal injury episodes to test applications of the tool. Information was collected on: demographics and general social, family, and individual characteristics of the injured firefighter; injury characteristics; return to work; and length of disability. A six step approach to the case management process was presented, with occupational health nursing activities offered in each step. Activities included: identification of case; assessment; return to work plan; resource identification; collaborative communication; and evaluation. Steps in the implementation of a case management program included: developing an educational in service training program for occupational clinic staff; conducting nursing audits quarterly to identify weak areas; using a history form with occupational, medical, vocational, and social history; conducting clinic staff meetings to discuss the progress of injuries identified for case management; conducting meetings with outside consultants; and communicating with injured employees and their supervisors both during treatment and upon return to work.
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