The effectiveness of advanced practice registered nurses with wound care specialization in the home setting on wound resolution and healthcare utilization
Abstract
Objective: The purpose of this study was to evaluate the effectiveness of advanced practice registered nurses (APRNs) with wound specialization on wound resolution and healthcare (HC) utilization for home health patients.
Methods: A quasi-experimental design with a convenience sample of 30 participants admitted to home health (HH) services compared to a retrospective chart review of 46 participants matched in terms of volume, wound type, wound size, gender, and age was used during the study. The APRN conducted a physical exam and history, obtained wound photography, developed a treatment plan, performed therapy, wrote orders for products and services, and provided a minimum of weekly follow-up visits. Healthcare utilization comprised time for healing, admits to a higher level of care, and amputations. Wound resolution was observed at 80% and 100% closure.
Results: The Intervention and Control Groups were comparable in terms of gender, wound type, age, and acuity, were similar regarding wounds per patient. Both groups achieved 80% volume, 80% area, and 100% wound resolution, regardless of wound types. The Intervention Group’s days to wound resolution was statistically significant for fewer days than the Control Group. This difference persisted after analysis of wound types within the groups. The Intervention Group had fewer acute care admits (10%) compared to the Control Group (50%), and the number of amputations was higher in the Control Group, with six amputations compared to only one in the Intervention Group.
Conclusions: Using APRNs with wound specialization improved patient outcomes, efficiency, and costs. The program should be evaluated for adoption and expansion. Further research into the impact of wound-specialized APRNs in the home setting is recommended.
Methods: A quasi-experimental design with a convenience sample of 30 participants admitted to home health (HH) services compared to a retrospective chart review of 46 participants matched in terms of volume, wound type, wound size, gender, and age was used during the study. The APRN conducted a physical exam and history, obtained wound photography, developed a treatment plan, performed therapy, wrote orders for products and services, and provided a minimum of weekly follow-up visits. Healthcare utilization comprised time for healing, admits to a higher level of care, and amputations. Wound resolution was observed at 80% and 100% closure.
Results: The Intervention and Control Groups were comparable in terms of gender, wound type, age, and acuity, were similar regarding wounds per patient. Both groups achieved 80% volume, 80% area, and 100% wound resolution, regardless of wound types. The Intervention Group’s days to wound resolution was statistically significant for fewer days than the Control Group. This difference persisted after analysis of wound types within the groups. The Intervention Group had fewer acute care admits (10%) compared to the Control Group (50%), and the number of amputations was higher in the Control Group, with six amputations compared to only one in the Intervention Group.
Conclusions: Using APRNs with wound specialization improved patient outcomes, efficiency, and costs. The program should be evaluated for adoption and expansion. Further research into the impact of wound-specialized APRNs in the home setting is recommended.
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PDFDOI: https://doi.org/10.5430/cns.v10n1p42
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Clinical Nursing Studies
ISSN 2324-7940(Print) ISSN 2324-7959(Online)
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