Susan J. Penner, RN, MN, MPA, DrPH, CNL

Author, Economics and Financial Management for Nurses and Nurse Leaders, Second Edition, 2013.  Dr. Penner is also a PD caregiver.

Nurses need to learn more about their role in managing Parkinson’s Disease (PD).  Part I of this series explains that an increasing number of American adults are disabled by this neurological disorder. Part II discusses the high and growing medical and non-medical costs of PD.  This final post suggests that nurses can help address this devastating and costly health problem, and find opportunities in improving PD care.

Inpatient Care Nurses

Staff nurses have important roles in improving inpatient care.  Although PD is most often seen in the elderly, the disease can affect people in their thirties.  A 2013 research study found that medication and symptom management are frequent concerns for inpatients with PD. By reducing medication errors, complications and discomfort, nurses can save the hospital money.

Staff nurses already know about the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).  HCAHPS scores affect hospital Medicare reimbursement.  By improving the care of inpatients with PD, nurses improve patient satisfaction and the hospital’s bottom line.

Nurses and families have at least one free resource to help improve PD inpatient care.  The National Parkinson Foundation Aware in Care program provides a free kit for patients and families that can be ordered from the Aware in Care website.  The kit includes an ID bracelet and a form to list all of the patient’s medications.  The kit also features informational materials helpful to hospital nurses and other providers to help manage medications and symptoms.  Nurses can educate themselves about PD, and encourage PD patients to contact Aware in Care.

Community-Based Nurses

Although persons with PD are sometimes hospitalized, most PD care occurs in the home and community.  Nurses can play crucial roles and find many opportunities in the outpatient and community care of persons with PD.  Patients and families need many services, from education to in-home support, and nurses can help fill the gaps in community-based programs.

One idea is a nurse-run case management service that provides patient assessment, referral to community resources, in-home and respite care and inpatient advocacy.  This service could operate as a for-profit business enterprise or a non-profit agency.  Nurses could work with neurology practices or contract with hospitals or accountable care organizations (ACOs) to provide patient-centered care in a medical home.

Another idea is to provide selected support services in the community.  For example, persons with PD are at risk for falls, depression and other problems that are helped by regular exercise.  A nurse-run exercise class that meets the needs of persons with PD in the community might be operated within a local senior center or community center.  Other services might include therapeutic art classes, caregiver support groups or yoga classes.  These classes might be offered for a fee, or as a nonprofit program funded by grants or donations.  Nurses who can write a successful business plan or grant proposal can implement these or other ideas for PD services.

This series explains how PD is a growing and costly health concern, especially among the elderly.  Nurses can take a win-win approach in addressing this concern.  Nurses are crucial in improving the quality of health care for people with PD.  Nurses can also find opportunities for consultation and community programs.  If nurses combine their healing skills with good financial practice, they can expand their careers and help the growing numbers of persons and families with PD get the care they need.