Comparación entre el coste y el cierre de heridas en una unidad de gestión clínica que incluye una enfermera de práctica avanzada en heridas crónicas complejas

Abstract

Introduction: Hard-to-heal or complex wounds that afflict a high percentage of the population, besides affecting the quality of life of the ones who suffer from them, impacts on a high economic cost, on nursing time and on hospital stays. Aims: Knowing the economic cost, complex wounds, average cost for closing and the average number of days for it that every nurse had compared to the Advanced Practice Nurse (APN) on complex chronic wounds from the unit. Methodology: Longitudinal descriptive study of the total injury assessment reports generated from the wounds application on DIRAYA (corporate healthcare information system for the entire Andalusian health service, unique Health Story of all citizen welfare episodes) and that needed healing material in a humid environment supplied by CMU. The study was developed in the Clinical Management Unit (CMU) of Algarrobo, belonging to the East Health Management Area of Málaga – Axarquía, since June 2019 until June 2020. This is a conceptual sample as the entire CMU nurse population and the corresponding pages issued by them have been included. Results: During the study period, a total of 416 wounds were registered in the Unit, of which 338 were closed, 81.2%. The APN treated 22.6% of the total wounds (94 wounds) and resolved the 90.4% of them, being the average cost for the wounds closure of 21.3 €, within an average of 30.7 days. While the rest of the professionals had to treat an average of 32.2 wounds and the average resolved was 76.7%, being the average cost for the wound closure of 36.2 € within an average of 172,1 days. Conclusions: The introduction of the APN on complex chronic wounds in the CMU had led the unit to a better result in terms of spending on materials and shortening the days for the wounds resolution, which influences a better quality of life for those who suffer from them. In addition, the introduction of the APN has served as a stimulus for professionals, leading them to do a better job with the wound, which influences both their professional self-esteem and as well as the patients they treat.