Nurse-Led Care Coordination in a Transitional Clinic for Uninsured Patients With Diabetes.

PURPOSE/OBJECTIVES: The purpose of this article is to inform the reader of the practice of the registered nurse care coordinator (RNCC) within an interprofessional, nurse-led clinic serving uninsured diabetic patients in a large urban city. This clinic serves as a transitional care clinic, providing integrated diabetes management and assisting patients to establish with other primary care doctors in the community once appropriate. The clinic uses an interprofessional collaborative practice (IPCP) model with the RNCC at the center of patient onboarding, integrated responsive care, and clinic transitioning. PRIMARY PRACTICE SETTING: Interprofessional, nurse-led clinic for uninsured patients with diabetes. FINDINGS/CONCLUSIONS: Interprofessional models of care are strengthened using a specialized care coordinator. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Care coordination is a key component in case management of a population with chronic disease. The RNCC, having specialized clinical expertise, is an essential member of the interdisciplinary team, contributing a wide range of resources to assist patients in achieving successful outcomes managing diabetes. Transitional care coordination, moving from unmanaged to managed diabetes care, is part of a bundled health care process fundamental to this clinic's IPCP model. In a transitional clinic setting, frequent interaction with patients through onboarding, routine check-ins, and warm handoff helps support and empower the patient to be engaged in their personal health care journey.

Surgical resection of atrial myxomas.

Myxomas are the most common form of benign cardiac tumors; these tumors occur primarily in the atria. Most myxomas are idiopathic in origin, but in rare cases, patients have a family history of myxomas. Although these tumors are benign, myxomas have the potential to cause serious complications, including embolic events and partial or complete obstruction of intracardiac blood flow. Currently, there is no effective medical treatment, and surgical excision of the tumor is necessary. Typically, surgical resection of an atrial myxoma is performed via a median sternotomy with the patient on cardiopulmonary bypass. Recurrence of a myxoma after surgical excision is extremely rare, and most patients have an excellent prognosis after surgery.