Health Care Initiative to Evaluate the Impact of a Nurse Practitioner Led Community Wound Care Service on Emergency Department Utilization
Abstract
Nurse Practitioners (NP) diagnose and treat wounds and wound-related conditions based on their advanced scope of practice. An NP with graduate-level wound care education (NP(W)) gains additional knowledge and clinical experience to provide comprehensive wound care.
This research aimed to explore community patients’ access to wound care in Southwestern Ontario (Canada). A quality improvement project was initiated utilizing stakeholder feedback to develop and implement a 12-week pilot NP(W)-Led community-based wound care service; the NP(W) wound care practices, clinical outcomes, and adverse events were described. One hundred twelve participants attended the service over 117 visits. The NP(W) services included prescribing and administering medications, providing treatments, ordering laboratory and diagnostic tests, sending referrals, and consultations.
Patient experience was captured via a mail-in survey of the Generic Short Patient Experiences Questionnaire. There were 49 completed questionnaires from the NP NP(W)-Led service. Respondents reported confidence in the NP(W) skills and satisfaction with the overall care.
Chart audits were conducted on 2066 charts to examine emergency department (ED) utilization before, during, and post-implementation of the NP(W)-Led wound care service. The most common reason for going to the ED was at the ED providers’ request, followed by being sent by a community nurse. There was a statistical difference between the total visits and visits for wound care at two points. Results from this small pilot study suggested a high-level patient satisfaction and noted decreased ED visits during the time the clinic was open.
Keywords: Nurse practitioner, NP, wounds, wound care, community, emergency department, patient experience, quality improvement project