accelerated wound healing in a community setting network...accelerated wound healing in a community...
TRANSCRIPT
Accelerated Wound Healing in a
Community Setting
Jane Hampton RN, MSc.
Wound Specialist Nurse
Aarhus Kommune
Study questions
1. Can the use of PICO heal chronic wounds more quickly than conventional treatments?
2. Can the use of PICO give economic savings when compared with conventional treatment?
*Funding for project: Aarhus Kommunes Innovation Fund
Method
• 9 patients 4 leg ulcers and 5 pressure ulcers
6 weeks – 5 years; av. 6 months
• PICO used for 14 days:
- all dressing changes = Wound specialist nurse
- photo and measurements: day 1, 7, 14
• Return to conventional treatment:
- follow up for 4 weeks after last PICO treatment - photo + measurements: day 7, 14 and 28
Results
Part 1. Healing rates: 3 cases
Part 2. Economic results: based on all 9 patients
Healing rates: Wound measurement (pleje.net)
PICO start: 11,6 cm2
After 14 days: 4,4 cm2
4 weeks post-PICO 1,7 cm2
Case 1. 88 yr old female. Venous leg ulcer: 5 months (30 cm2) Conventional treatment: 3 – 4 weekly with 2-layer compression
Anslået besparelse ved heling i uge 3 - 12 uger af borgerens tid - 7,5 sygeplejerske timer -4.300 kr.
Case 1: Wound healing
PICO 14 days 38% weekly
Healed in week 3 21 % weekly
Wo
un
d s
ize c
m2
10%
Estimated to heal in week 15 with conventional treatment
7% weekly
Case 7 56 yr old female. Pressure ulcer on hip: 2+ months. (48 cm2) Conventional treatment: daily dressing change
PICO start: 37,5cm2
After 14 days: 20,5cm2
4 weeks post-PICO: 10,1 cm2
PICO 14 days 31% weekly
Healed in week 19 28% weekly
Estimated to heal in week 42 with conventional treatment
Case 7. Wound healing
7% weekly
PICO start: 3,4 cm2
After 14 days: 2,5 cm2
4 weeks post-PICO: 0,2 cm2
Case 9. 76 yr old male. Venous leg ulcer: 7 months with no change. Conventional treatment: Compression x 2 weekly
PICO 4 and 7 days ( 4 day pause with visit to København)
Case 9. Wound healing
Healed in week 27
Estimated healing…. 1 year with conventional treatment
0-1 % weekly
0
10
20
30
40
50
60
70
80
90
1 2 3 4 5 6 7 8 9
Pe
rce
nt
Patient
Weekly reduction in wound size (%) PICO vs. conventional treatment
Question 2: Economics
Cost saving:
- when we fulfil an objective (wound healing) at a lower cost than the projected cost (conventional treatment)
Projected cost: frequency of wound dressing change
: price of products used
: nurses time used in wound care
in relation to : speed of healing
0
2
4
6
8
10
12
14
Nu
mb
er
of
tret
me
nts
Frequency of wound treatments over 14 days
PICO vs conventional treatment
1
2
3
4
5
6
7
8
9
Patient
Conventional treatment With PICO Conventional treatment pre-PICO 14 days post-PICO
0
100
200
300
400
500
600
700
800
900
1000
1 2 3 4 5 6 7 8 9
Pe
rce
nt
dif
fere
nce
Patient
Difference in weekly treatment costs (%) and weekly healing rate (%) with PICO (14 days) when compared to conventional
treatment pre-PICO
1600 % 1300 %
Increase in treatment costs Increase in healing rate
1600 % 1300 %
Conventional treatment and healing = 0
Anslået besparelse ved heling i uge 3 - 12 uger af borgerens tid - 7,5 sygeplejerske timer -4.300 kr.
Case 1: Potentially shortened care package
PICO 14 days 38% weekly
Healed in week 3 21 % weekly
Wo
un
d s
ize c
m2
Estimated to heal in week 15 with conventional treatment
Savings :
12 weeks Nursing time
Products
CHEAPER END RESULT: Estimated savings to wound size reached with PICO (14 days) compared to
a continued consistent healing rate with conventional treatment
0 2.000 4.000 6.000 8.000 10.000 12.000 14.000 16.000 18.000 20.000
1
2
3
4
5
6
7
8
9
Kroner
Pat
ien
t
6 weeks and 9 nurse hours
5 weeks and 5 nurse hours
No savings – could not seal PICO
6 weeks and 6 nurse hours
12 weeks and 10 nurse hours
23 weeks and 12 nurse hours
1 week and 2 nurse hours
16 weeks and 32 nurse hours 12 weeks and 6 nurse hours
Conclusion
When compared to conventional treatment the use of PICO can result in:
1. Faster healing rates:
- both during and after treatment with PICO
2. Economic savings:
- Fewer nurse contacts each week for wound care
- Shorter nurse contact time to each wound care
- Shorter treatment care package