More Effective, Less Expensive: Evaluation of an Evidence-Based Regional, Nurse-Led Chronic Wound Service

2.50
Hdl Handle:
http://hdl.handle.net/10755/155814
Type:
Presentation
Title:
More Effective, Less Expensive: Evaluation of an Evidence-Based Regional, Nurse-Led Chronic Wound Service
Abstract:
More Effective, Less Expensive: Evaluation of an Evidence-Based Regional, Nurse-Led Chronic Wound Service
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Conference Date:July 10-12, 2003
Author:Harrison, Margaret, RN, PhD
P.I. Institution Name:Queen's University
Title:Senior Scientist, Associate Professor, and Career Scientist
Co-Authors:E. Friedberg, I.D. Graham, K. Lorimer
Objective: An initiative to deliver ‘best practice’ with chronic wound care was undertaken in one large Canadian community. This involved: evaluating international practice guideline recommendations, developing the local protocol, conducting a prevalence survey and regional needs assessment, assisting the planners with the clinical/organizational redesign for the new service. Design: One-year pre-post evaluation study has been completed from the clinical and health services perspective.<P> Population, Setting, Years: Chronic wound population, Canadian, urban-rural area of 1,000,000. Home care and Nurse Clinics. Study period 2000-2002. Intervention, Outcome Variables: With the new service, nurses provided care to all clients regionally with chronic leg ulcers referred to home care using an evidenced-based clinical protocol. The service model involved all-RN team of primary and secondary nurses with streamlined links to specialist physicians. The results of the one-year pre-post analysis will be presented comparing clinical, service, and economic outcomes.<P> Results: We followed 161 clients pre-implementation, and following implementation, 409 clients were admitted with venous, mixed and/or arterial leg ulcers. There were no significant differences between pre- and post-groups in socio-demographic and clinical variables (comorbidities, chronicity, size, location, duration of ulcer). After implementation, significant differences were found in healing rates: 23% healed at 3 months pre- compared with 52% post-implementation. The venous ulcer healing rate was 24% pre-implementation compared with 64% after. Visits per week dropped from 3.2 to 2.4, with the proportion of daily visits decreasing from 44% to 8%. Weekly supply costs decreased from $119 to $48.<P> Conclusions: Implementation of evidence-based care in the community for the leg population has resulted in more effective, less expensive services. Healing rates at 3 months have more than doubled; scarce nursing time is being utilized more efficiently. Implications: The region is providing care to more people with leg ulcer problems for less cost and with less nursing staff. <!--Abstract 13946 modified by 134.68.166.31 on 11-11-2002--></P></P></P>
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Jul-2003
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleMore Effective, Less Expensive: Evaluation of an Evidence-Based Regional, Nurse-Led Chronic Wound Serviceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155814-
dc.description.abstract<table><tr><td colspan="2" class="item-title">More Effective, Less Expensive: Evaluation of an Evidence-Based Regional, Nurse-Led Chronic Wound Service</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 10-12, 2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Harrison, Margaret, RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Queen's University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Senior Scientist, Associate Professor, and Career Scientist</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">harrisnm@post.queensu.ca</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">E. Friedberg, I.D. Graham, K. Lorimer</td></tr><tr><td colspan="2" class="item-abstract">Objective: An initiative to deliver &lsquo;best practice&rsquo; with chronic wound care was undertaken in one large Canadian community. This involved: evaluating international practice guideline recommendations, developing the local protocol, conducting a prevalence survey and regional needs assessment, assisting the planners with the clinical/organizational redesign for the new service. Design: One-year pre-post evaluation study has been completed from the clinical and health services perspective.&lt;P&gt; Population, Setting, Years: Chronic wound population, Canadian, urban-rural area of 1,000,000. Home care and Nurse Clinics. Study period 2000-2002. Intervention, Outcome Variables: With the new service, nurses provided care to all clients regionally with chronic leg ulcers referred to home care using an evidenced-based clinical protocol. The service model involved all-RN team of primary and secondary nurses with streamlined links to specialist physicians. The results of the one-year pre-post analysis will be presented comparing clinical, service, and economic outcomes.&lt;P&gt; Results: We followed 161 clients pre-implementation, and following implementation, 409 clients were admitted with venous, mixed and/or arterial leg ulcers. There were no significant differences between pre- and post-groups in socio-demographic and clinical variables (comorbidities, chronicity, size, location, duration of ulcer). After implementation, significant differences were found in healing rates: 23% healed at 3 months pre- compared with 52% post-implementation. The venous ulcer healing rate was 24% pre-implementation compared with 64% after. Visits per week dropped from 3.2 to 2.4, with the proportion of daily visits decreasing from 44% to 8%. Weekly supply costs decreased from $119 to $48.&lt;P&gt; Conclusions: Implementation of evidence-based care in the community for the leg population has resulted in more effective, less expensive services. Healing rates at 3 months have more than doubled; scarce nursing time is being utilized more efficiently. Implications: The region is providing care to more people with leg ulcer problems for less cost and with less nursing staff. &lt;!--Abstract 13946 modified by 134.68.166.31 on 11-11-2002--&gt;&lt;/P&gt;&lt;/P&gt;&lt;/P&gt;</td></tr></table>en_GB
dc.date.available2011-10-26T14:11:58Z-
dc.date.issued2003-07-10en_GB
dc.date.accessioned2011-10-26T14:11:58Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.