A key strategy for reducing home care cost is to reduce nurse visit utilization. The purpose of this pilot study was to measure the impact of implementing standardized wound care protocols with educational self-care materials on skilled nurse utilization. METHODS: Wound care visits for a home care agency in Green Bay, Wisconsin were studied retrospectively from the facility's databases for a six month period in 2003. Wound care cost and skilled nursing utilization data for pressure ulcers and open surgical wounds were compared to data prospectively collected over the same period in 2004. For the prospective phase of the study, a wound care formulary, care plans, and caregiver teaching guides were standardized across the agency. RESULTS: The median (range) number of skilled nursing visits per patient significantly decreased from 18.5 (4-158) to 8.0 (2-43), pre- and post-intervention (p<0.01). The median (range) number of days of home care service decreased from 32.0 (12-154) to 30.0 (3-62), which was not significantly different (p=0.15). The median (range) cost of wound care per patient decreased from $876.60 ($198.10-$7,855.80) to $543.40 ($124.90-$5,629.00), which trended toward significance (p=0.08), and was driven primarily by decreased labor costs. Wound outcomes were not significantly different (p = 0.12). CONCLUSIONS: Implementation of standardized wound care products and protocols, combined with patient self-care teaching guides, helped decrease the average number of nurse visits in this home care agency. This was accomplished by shifting the role of the wound care nurse from that of a direct wound care provider to that of an educator/facilitator. The trend toward lower treatment cost per patient indicates that labor cost savings offset the added cost of the use of advanced dressings. Patient outcomes were similar pre- and post-intervention, indicating that these cost savings were accomplished without sacrificing quality of care.

*3M In-Home Wound Care Solutions