Managing wound care outcomes

Area of Science:

• Healthcare Management
• Wound Care Research
• Public Health Policy

Background:

• Chronic wounds represent a significant financial burden on home care systems.
• Existing wound care practices in Nova Scotia prior to 1999 were costly and yielded suboptimal patient outcomes.
• There was a need for standardized, evidence-based protocols to improve chronic wound management in home care settings.

Purpose of the Study:

• To assess the prevalence, costs, and outcomes of chronic wound care in Nova Scotia Home Care.
• To develop and implement a standardized prevention and treatment protocol for chronic wounds.
• To evaluate the impact of the protocol on wound outcomes and healthcare costs.

Main Methods:

• A four-phase study involving retrospective chart review, protocol development using best evidence, protocol dissemination, and prospective outcome measurement.
• Utilized an Outcomes Management Model research framework and a quasi-experimental, descriptive study design.
• Data collected included wound prevalence, costs of care, healing times, and frequency of dressing changes.

Main Results:

• Pre-protocol: high prevalence of pressure ulcers (30%), frequent daily visits (42%), and low use of compression therapy for venous leg ulcers (16/115 clients).
• Post-protocol: reduced chronic wound prevalence, decreased dressing change frequency, shorter healing times, and significant cost savings.
• Average monthly cost reduction of $946.64 per client after protocol implementation.

Conclusions:

• The Nova Scotia Standardized Prevention and Treatment Protocol effectively improved chronic wound care quality and reduced associated costs.
• The protocol enhanced awareness of moist wound healing principles among home care professionals.
• The successful protocol has been adopted as official policy for Home Care in Nova Scotia, demonstrating its value and efficacy.