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Purpose: A Canadian specialty nursing association identified the
necessity to examine the role and impact of Enterostomal Therapy (ET) nursing in
Canada. A retrospective analysis of the cost‑effectiveness
and benefits of ET nurse‑driven resources for the treatment of acute and
chronic wounds in the community was undertaken.
Design: A multi‑center retrospective pragmatic chart audit conducted a review of
three nursing care models from four community nursing agencies
and one company owned and operated by ET nurses. An analysis
was completed utilizing quantitative methods to evaluate healing
outcomes, nursing costs and cost‑effectiveness.
Main Outcome Measures: Kaplan Meier estimates were calculated to
determine the average time to 100% healing of acute and chronic wounds and
total costs in a community setting.
Average direct nursing costs were determined by number of nursing visits and reimbursement for
each visit.
Results: 496 charts were audited. An RN with ET or Advanced Wound Ostomy Skills (AWOS) was associated with lower overall costs: reduced time to 100% closure of the wound; and reduced number of nursing visits.
Differences in health benefits and total costs between the ET/ AWOS
and hybrid nursing group was a reduction in healing time of 45 days and a cost difference of $5,927.00 per chronic wound.
Increased ET/ AWOS involvement demonstrated significant faster time to 100% closure at a lower
mean cost.
Differences in health benefits and total costs between the ET/ AWOS and hybrid nursing group was a
reduction in healing time of 95 days and an expected cost difference of $9,578.00 per acute wound.
There was a significant difference in healing times and reduced mean cost as the ET/ AWOS became
more involved in the treatment.
Conclusions: The greater involvement directly and indirectly by an ET/ AWOS nurse in the management of wounds demonstrated greater savings and shorter healing times.