Study may produce new best practices
Study may produce ew best practices
Wound care outcomes, economics being studied
A major study now under way may offer precise insights into and new protocols for the prevention and treatment of wounds. It also may provide some hard data on costs.
"By studying the processes of prevention and treatment, we would like to be able to determine which ones lead to the best outcomes with regard to healing and prevention, and from that develop some type of best-practice protocol," says Stacy Bender, MS, RD, associate clinical project leader at Ross Products Division of Abbott Laboratories in Columbus, OH.
Ross Products is the primary source of funding for the study, which includes 2,500 patients. About half of those patients are at risk of developing pressure ulcers, and half have at least one pressure ulcer.
The goal of the study is to collect outcomes data from patients in long-term care facilities and then determine what measures can be applied to prevent and treat pressure ulcers most effectively.
About 20% of the analysis will deal with the role of nutrition in wound care, Bender reports. The subject is naturally of great interest to the company, which owns the largest market share of the health care enteral nutrition market.
"We feel strongly that nutrition is a big part of the picture, and we predict the study results will show that. But we also realize that you need to look at the entire care process," she says.
160,000 beds represented
Patient data are being supplied by an array of long-term care facilities belonging to five of the nation’s largest health care companies, which represent more than 160,000 beds. Each is paying for the cost of data-gathering at its own facility. Data collection from patient charts is virtually complete, Bender adds.
Ross Products estimates its contribution to the project at more than $1 million. Nineteen abstracters were needed during the project’s data-collection phase. Data analysis, which is expected to take two months, will be conducted by International Severity Information Systems Inc. of Salt Lake City, which will apply a new research methodology known as clinical practice improvement (CPI).
Outcome variables to be analyzed include the rate of development of pressure ulcers as well as the length of healing time associated with various treatments, such as nursing care, support surfaces, dressings, medications, and nutritional interventions. According to Ross Products, CPI adjusts for the severity of illness and co-morbidity and applies a scientific method to the day-to-day practice of medicine.
A company report says it "analyzes the content and timing of individual steps of the medical care process in order to determine how to achieve better medical outcomes for the least necessary cost." The company also estimates that the prevalence of pressure ulcers in the long-term care population ranges from 2% (which is generally considered low) to as high as 30%.
A second portion of the study will consider the economic implications of the findings and should be completed early in 1998. That analysis will be conducted by Vector Research Inc. of Ann Arbor, MI. During the economic analysis, the best practices determined during the earlier analysis will be linked with associated costs, Bender explains. "We’ll be using an activity-based cost approach," she says. "For example, we’ll compare the treatment costs of two different wound dressings by looking at factors such as how long it takes a nurse to change a dressing, how much the nurse gets paid, and how many days it takes for healing to occur."
The company reports that the results of the project will add to the body of knowledge regarding what works and does not work in the treatment and prevention of pressure ulcers. Company executives say they hope the new information will allow health care providers to capitalize on the treatments and procedures that produce positive results and eliminate those that do not.
Once the study is completed, Ross Products intends to disseminate the results to the wound care community, perhaps through vehicles such as journal articles. "We want to get the information out there," Bender says.
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