Making the case for cost-effective wound management. Professor Keith Harding, Cardiff University, UK
|
|
- Jeffry Leo Dean
- 5 years ago
- Views:
Transcription
1 Making the case for cost-effective wound management Professor Keith Harding, Cardiff University, UK
2 Making the case for cost-effective wound management Clinicians who treat patients with wounds need access to resources that deliver the best and most appropriate treatments However, tension exists between resource availability and demand Increasing cost of healthcare Constrained healthcare budgets Choices and sacrifices Aging population... increasing prevalence and incidence of wounds
3 Types of wounds 1 Acute wounds Chronic wounds Traumatic wounds Total wounds 300+ million 20 million 100+ million 400+ million Surgical wounds Lacerations Skin grafts Cosmetic Pressure ulcers Leg ulcers Diabetic ulcers Burns Trauma Increasing Public health Tolerance
4 Cost estimates 1 Traditional Advanced dressings Actives Total spend $2.1 billion $3.2 billion $0.7 billion $70+ billion Gauze Absorbents Moist wound dressings NPWT Active Dressings Biologicals Surgery Biologicals Dressings Bandages Adjuncts Beds Care time Pharma
5 How do you measure success to secure funding? Wounds healed? Wound-free days? Decrease in pain, odour or exudate? Eradication of infection? Increase in patients quality of life? Changes in patients /caregivers experiences? Improved cost-effectiveness? Unrealistic to use complete healing as primary outcome measure more appropriate to adopt broader-based approach 2
6 Challenges to cost-effective wound management 3,4 Need to understand true costs of wound care to defend services 3 How can we demonstrate that a health intervention offers value for money for the patient benefits it provides? Health economics can help using data on efficacy, effectiveness and cost 4 However, in wound management there is: lack of consistency in cost/resource-usage data collection and in best practice application limited data on clinical efficacy and effectiveness
7 New international consensus 4 Document aims to help clinicians, budget-holders, payors, etc to: understand what is meant by 'cost-effective wound management' appreciate the different types of economic analysis used in healthcare interpret information on the cost and cost-effectiveness of wound care modalities and protocols set up systems to collect the data for analysis make an appropriate case for cost-effective wound management
8 What is cost-effectiveness? 4 A cost-effective intervention provides clinical benefits at a reasonable cost, and the benefits provided exceed those that would be gained if the resources were used elsewhere Being cost-effective is sometimes equated with being inexpensive or cost-saving, but often this is not the case Terminology can be confusing and may have multiple meanings in everyday language require clear definitions to avoid misinterpretation
9 Types of economic analysis 4 Assessing the cost-effectiveness of a health intervention is about examining the balance between cost and benefit Type Cost or burden of illness Cost-minimisation Cost-effectiveness* Cost-utility Cost-benefit Cost-consequences Comments *Sometimes also known as a cost-benefit study Determines how much a particular disease costs individuals, the healthcare system, the economy and society Does not indicate value for money Measures the costs of treatments with identical outcomes Measures the costs of achieving a defined unit of outcomes, eg cost per wound healed, amputation avoided or life-year gained Measures costs in terms of survival and quality of life Measures both costs and benefits in monetary terms, eg cost per QALY Quantifies all outcomes and relates them to the costs for each of a range of alternative courses of action
10 What are costs? 4 Direct and indirect costs which to include depends on the perspective of the analysis Direct costs Diagnostic tests Primary and secondary dressings, tape, cleansers, bandages, support stockings, medication and other materials costs Clinician time (eg nursing and medical) Hospital/clinic overheads (eg administration services, building costs, heating, lighting, cleaning, etc) Costs of transporting the patient to the health service Indirect costs Loss of income by patients and/or their carers due to reduced time at or ability to work Costs due to reduced ability to undertake domestic responsibilities, eg cleaning or caring for others Welfare, social security or disability payments by government or insurance company
11 Costs 4 Direct costs are easier to collect, but may not fully represent the economic impact of a wound or its treatment To aid comparisons, economic analyses of wound care interventions should specify amounts for each resource analysed, eg number of hours of clinician time and number of dressings used, in addition to the monetary costs and the date and source of the valuation for each
12 Outcome measures 4 Should be appropriate for the condition and intervention being studied, and ideally should be meaningful to patients Outcome measures used to compare different interventions should have the same units The wide variety of outcome measures used in wound management research hinders comparisons of interventions and progress We urgently need to develop patient-centred outcomes and international agreement on which outcome measures should be used
13 Interpreting cost studies 4 Requires care studies are very variable in approach and quality The cheapest intervention is not necessarily the most cost-effective Some agencies use QALY thresholds, eg NICE in the UK ( 20,000 30,000/QALY)
14 Data collection 4 We need to develop consistency in what data we collect Using data collected as part of routine clinical contact provides opportunities for accumulating data Know what you are measuring and why Develop uniform collection methods Involve a statistician and/or health economist Consider health-related and patient-related QOL Consider starting on a small scale, then scale up to involve more centres to allow larger amounts of data to be collected over a wider area
15 What do we know? 4 There is limited information on cost and costeffectiveness for wound management What information is available varies considerably by country In general, cost analyses of wound management produce underestimates because measurement and valuation of all costs in monetary terms is not usually possible It is clear that cost-effective wound management will include treatment of the underlying cause and treatment of the wound itself
16 Myths about cost-effectiveness 4 Myth: Cost-effective means cheaper or costsaving Myth: An intervention is either cost-effective or not cost-effective Myth: Evidence of cost-effectiveness is sparser and more difficult to acquire than in other areas of healthcare Myth: Analysis of cost-effectiveness is too difficult and time-consuming to undertake Myth: A favourable cost-effectiveness analysis will in itself gain the intervention funding or reimbursement and adoption into clinical practice, and is the only parameter of interest to payors
17 Making the case 4 Identify and engage with key stakeholders and understand their different perspectives. Consider providing information to answer: What is the scale of the problem? What is the target group of the intervention? What is the evidence base? Are there examples from the real world? How long is the intervention required? What is the payment/reimbursement? Is the intervention affordable? What are the costs and how cost-effective is the intervention? What are the benefits to staff/organisation/healthcare setting or system? How will the new intervention fit into the current system? What education/training costs and additional resources are needed? What are the risks?
18 Making the case 4 Keep your argument short and straightforward; avoid technical language Use your clinical expertise to provide stakeholders with a deeper knowledge of wound management Demonstrate what good wound management can achieve use simple measures such as clinical photographs Educate stakeholders to look at the big picture cost savings in one area may increase resource usage elsewhere Your data are powerful develop your argument carefully and be aware of any unintended consequences Remember: you are the catalyst for improving patient care
19 Challenges: wound infection Wound infection is a common complication At least 5% of patients develop an SSI after a surgical procedure 5 Around 50% of chronic wounds may be infected 6 Determining wounds that are infected is often difficult No diagnostic tools Need to use other ways of identifying wound infection
20 Challenges: identifying infection
21 Challenges: identifying infection
22 Challenges: clinical evidence base The routine use of antibiotics is not justified for colonised or infected wounds 7 Need to identify patients who may benefit from treatment with a topical antimicrobial such as silver 8 BUT there is an absence of high-level evidence 9 Need to THINK, REFLECT and EVALUATE
23 Making a case for silver Silver dressings play an integral role in the topical management of wound bioburden 10 Judicious use of silver is central to ensuring sustainability of these products BUT misunderstanding can lead to misuse International consensus documents have highlighted the need to use antimicrobial dressings appropriately to help manage wound infections 7,11
24 Principles for appropriate use 10,11 Follow a best-practice approach to determine the need for a silver dressing do not use if no clinical signs of infection Choose the most appropriate silver dressing to meet a patient s needs Read manufacturer s instructions for use Know how long to use the silver dressing for
25 The two-week challenge 11 The 2012 silver consensus group suggested that the first two weeks of treatment with a silver dressing can be seen as a challenge period during which the efficacy of the silver dressing can be assessed Ongoing assessment and re-evaluation will provide guidance on the need to continue, alter or discontinue the use of a silver dressing
26 Effect of two-week challenge The two-week challenge can lead to: Timely interventions to control infection Avoidance of repeating treatments that don t work Better outcomes Reduction in cost of silver dressings 12 Remember cost-effectiveness is not determined by direct cost alone. Consider ease of use, wear time, nursing visits and efficacy of dressing in reducing wound bioburden
27 Conclusion Chronic wounds represent a large and growing burden for patients and healthcare providers 1 3 It is important that we use limited resources effectively the right product, on the right wound, at the right time, for the right patient 4 Timely and appropriate use of topical antimicrobial agents and dressings, such as silver, is important to meet clinical and patient needs 10,11 Implementation of effective treatment protocols can lead to better utilisation of resources and improved cost-efficiency 4
28 References 1. Harding K, Queen D. A 25-Year Wound Care Journey within the Evolution of Wound Care. Adv Skin & Wound Care 2012; 25(2): Grey D, Leaper D, Harding K, Editorial BMJ 24 April Harding D, Posnett J, Vowden K. A new methodology for costing wound care. Int Wound J 2013; 10: International consensus. Making the case for cost-effective wound care. An expert working group consensus. London: Wounds International, Available from 5. National Institute for Health and Clinical Excellence (2008) Quick reference guide: surgical site infection. London: NICE. Available from 6. Reddy M, Gill SS, Wu K et al. Does this patient have an infection of a chronic wound? JAMA 2012;307(6): World Union of Wound Healing Societies (WUWHS). Principles of best practice: Wound infection in clinical practice. An international consensus. London: MEP Ltd, Available from 8. Best Practice Statement: The use of topical antimicrobial agents in wound management. Wounds UK Available from 9. Beam JW. Topical silver for infected wounds. J Athl Train 2009; 44(5): Moore Z. How to...top tips on when to use silver dressings. Wounds Int 2013; 4(1). 11. International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. London: Wounds International, Available from Searle R, Bielby A. Dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster presented at Wounds UK, Harrogate Nov 2010.
Care Bundle Wound Care Guidance
Care Bundle Wound Care Guidance A wound may be defined as a break in the structure of an organ or tissue caused by an external agent; for example, a bruise, cut, or burn (Oxford Living Dictionaries, 2017).
More informationResearch from the Health Protection Agency
Changing wound care protocols to reduce postoperative caesarean section infection and readmission KEY WORDS Caesarean section Infection Diabetes Obesity PICO Opsite Post-Op Visible Due to concern centring
More informationWound Assessment: a case study approach
Leg Club Conference Workshops 24 th September 2014 Wound Assessment: a case study approach Mark Collier Lead Nurse Consultant Tissue Viability United Lincolnshire Hospital NHS Trust mark.collier@ulh.nhs.uk
More informationPressure Ulcers The BHTA guide to prevention and cash releasing savings
Pressure Ulcers The BHTA guide to prevention and cash releasing savings Pressure Ulcers: The BHTA guide to prevention and cash releasing savings In the UK, around 400,000 individuals develop a new Pressure
More information(NHS) continues to seek costeffective
Cost-effective management of wound exudate This clinical evaluation explores the complex challenges involved in managing exudate as part of a holistic wound treatment plan. The benefits of using Kliniderm
More informationA fresh approach to challenging wounds by. combining T.I.M.E. with pioneering solutions. Thursday, 10 May :15 14:15, Bratyslawa
Abstract booklet A fresh approach to challenging wounds by 1,2 combining T.I.M.E. with pioneering solutions Thursday, 10 May 2018 13:15 14:15, Bratyslawa Faculty: Dr Caroline Dowsett (UK) Dr Matthew Malone
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
Managing pressure ulcers in neonates, infants, children and young people bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They
More informationIn recent years, numerous products have
Vacutex 7/1/02 5:18 pm Page 1 Review of an independent audit into the clinical efficacy of VACUTEX TM Michelle Deeth Abstract An independent report was completed and analysed by Pharmaceutical Research
More information* At smith&nephew our products promote wellbeing which helps to reduce the human and economic cost of wounds. Abstracts Booklet
* At smith&nephew our products promote wellbeing which helps to reduce the human and economic cost of wounds. Abstracts Booklet Smith & Nephew EWMA satellite symposium Wednesday 15th May 2013 Designing
More informationWounds UK. Evaluating adhesive foam wound care dressings in clinical practice. Victoria Peach
Wounds UK valuating adhesive foam wound care dressings in clinical practice Victoria Peach This article was published in the Wounds UK Journal 2012, Vol 8, No 3 2761_victoriapeach_woundsUK.indd 1 29/10/2012
More informationThe Angior trial: community nurse perceptions of wound best practice initiatives
The Angior trial: community nurse perceptions of wound best practice initiatives Flowers C, Kapp S, Lewin G, Newall N, Carville K, Gliddon T Abstract A survey of nurses from two community nursing services
More informationManagement of Negative Pressure Wound Therapy (NPWT) Guideline
Management of Negative Pressure Wound Therapy (NPWT) Guideline Contents Management of Negative Pressure Wound Therapy Guideline... 1 Purpose... 1 Scope/Audience... 2 Associated documents... 2 Definitions...
More informationPatient & Wound Assessment
EWMA Educational Development Programme Curriculum Development Project Education Module: Patient & Wound Assessment Latest revision: February 2014 ABOUT THE EWMA EDUCATIONAL DEVELOPMENT PROGRAMME The Programme
More informationMETICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (M.R.S.A.) DECOLONISATION GUIDANCE PRIMARY CARE. Purpose of Issue/Description of Change
METICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (M.R.S.A.) DECOLONISATION GUIDANCE PRIMARY CARE First Issued by/date Issue Version Purpose of Issue/Description of Change Planned Review Date 10/2008 1 Guidance
More informationTopical Negative Pressure
Accessible, Responsive Community Healthcare South Birmingham Community Health Adults and Community Division Topical Negative Pressure Wound Assessment and Plan of Care Document Topical Negative Pressure
More information8/11/2009. Staging Assessment Nutrition Pain Support Surfaces Cleansing. Debridement Dressings Infection Biophysical Agents Surgery Palliative Care
8//9 Joyce Black, PhD, DNP, RN, CPSN, CWCN, FAPWCA Past President, NPUAP AHCPR guidelines 99, 99 Various Wound Groups WOCN, WHS, Medical Directors Focus was narrow, not adding to evidence EPUAP on nutrition
More informationImproving patient outcomes: NHS England's workstream for the lower limb
Improving patient outcomes: NHS England's workstream for the lower limb KEY WORDS Chronic wounds Leading Change Adding Value Lower limb Framework NHS Data on chronic wounds and how it affects people who
More informationOptimising Systems and Processes of Wound Care - A QIPP resource of good practice. Developing and Implementing a Wound Care Prescribing Policy
East & outh East England pecialist Pharmacy ervices East of England, London, outh Central & outh East Coast Medicines Use and afety Optimising ystems and Processes of Wound Care - A QIPP resource of good
More informationExpression of Interest for Wound Care Project
Expression of Interest for Wound Care Project November 11, 2016 Telewound Care EOI Page 1 of 12 Contents 1 Introduction... 3 2 Telewound Care Project Background... 4 2.1 Background... 4 2.2 Purpose...
More informationPROCEDURE FOR TAKING A WOUND SWAB
CLINICAL PROCEDURE PROCEDURE FOR TAKING A WOUND SWAB Issue History Issue Version Purpose of Issue/Description of Change Planned Review Date 2 To provide a standardised process of the fundamental principles
More informationIntroduction to Wound Management
EWMA Educational Development Programme Curriculum Development Project Education Module: Introduction to Wound Management Latest revision: October 2016 ABOUT THE EWMA EDUCATIONAL DEVELOPMENT PROGRAMME The
More informationThe Royal Wolverhampton NHS Trust
The Royal Wolverhampton NHS Trust Trust Board Report Meeting Date: 24 June 2013 Title: Executive Summary: Action Requested: Report of: Author: Contact Details: Resource Implications: Public or Private:
More informationCLINICAL PROCEDURE CONSERVATIVE SHARP DEBRIDEMENT FOR COMMUNITY PODIATRISTS
CLINICAL PROCEDURE CONSERVATIVE SHARP DEBRIDEMENT FOR COMMUNITY PODIATRISTS Issue History Issue Version Purpose of Issue/Description of Change Planned Review Date 1 To provide Podiatrists with the fundamental
More informationTHE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST REDUCING HARM TISSUE VIABILITY PROGRESS REPORT
Agenda item A5(iv) THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST REDUCING HARM TISSUE VIABILITY PROGRESS REPORT EXECUTIVE SUMMARY The Tissue Viability Team assists wards and departments to reduce
More informationImplementing a wound assessment and management system (WAMS)
Southern Cross University From the SelectedWorks of Dr Joanne Rowley Fall May, 2006 Implementing a wound assessment and management system (WAMS) Karen Saunders Joanne Rowley, Southern Cross University
More informationImplications of Pressure Ulcers and Its Relation to Federal Tag 314
SPECIAL ARTICLE Implications of Pressure Ulcers and Its Relation to Federal Tag 314 Courtney H. Lyder, ND The Centers for Medicare & Medicaid Services (CMS) released the revised Federal Regulation for
More informationCCG GOVERNANCE BOARD EXECUTIVE SUMMARY SHEET
CCG Governance Board Agenda Item 7.2 DATE: 14 th November 2017 CCG GOVERNANCE BOARD EXECUTIVE SUMMARY SHEET TITLE OF PAPER: EXECUTIVE RESPONSIBLE: Telford and Wrekin Wound Healing Service Fran Beck Contact
More informationCreating viable options
A tool for identifying key education content areas to support progressive development in tissue viability for health and social care care staff April 016 Contents Published July 009 Updated October 015
More informationClinical and financial outcomes with Allevyn Gentle Border Lite
Clinical and financial outcomes with Allevyn Gentle Border Lite The current healthcare environment has prompted healthcare professionals to consider carefully the clinical and financial outcomes of wound
More informationWound Care and. February Lymphoedema Service
Wound Care and February 2016 Lymphoedema Service Contents Introduction... 2 About the service... 2 Service provision... 2 Advice, education and training... 4 Service locations and hours of operation...
More informationLocally Commissioned Services report
Locally Commissioned Services report Locally Commissioned Services are services that have been agreed locally between the CCG and our practices to meet the identified needs and priorities of our population.
More informationDebridement is defined as the
Debridement consensus: Recommendations for practice It is important in today s NHS for the safety and wellbeing of patients, and given that financial penalties are imposed when deep pressure ulcers develop
More informationHCS-D Skill Assessment Questions
HCS-D Skill Assessment Questions These questions represent the variety of subjects and thought-processes that are involved in the HCS-D exam. All of the questions on the certification and re-certification
More informationPROCEDURE FOR CONSERVATIVE DEBRIDEMENT
CLINICAL PROCEDURE PROCEDURE FOR CONSERVATIVE DEBRIDEMENT Issue History Issue Version One Purpose of Issue/Description of Change To promote safe and effective sharp debridement by Tissue Viability Specialists
More informationWilliam J. Ennis D.O.,MBA University of Illinois at Chicago Professor Clinical Surgery, Chief Section wound healing and tissue repair
William J. Ennis D.O.,MBA University of Illinois at Chicago Professor Clinical Surgery, Chief Section wound healing and tissue repair What are the revenue streams What are the expenses How does the hospital
More informationAll Ireland Conference
Initial Results from the LIMPRINT study All Ireland Conference November 15 th 2017 Professor Christine Moffatt CBE (on behalf of ILF) University of Nottingham ILF Chair Outline of presentation : The development
More informationThe Certainty of Acelity. in Skilled Nursing and Long Term Care
IN PERSON PRODUCT TRAINING & EDUCATION Over 300 representatives focused on empowering customers to use Acelity products safely and effectively VIRTUAL LIVE & ON DEMAND Acelity also offers live and interactive
More informationHealth First Europe calls on the EU Institutions to Champion Patient Safety
Health First Europe calls on the EU Institutions to Champion Patient Safety Recommendations on Patient Safety Since 2004, Health First Europe has been actively involved in the issue of patient safety at
More informationObjectives 2/23/2011. Crossing Paths Intersection of Risk Adjustment and Coding
Crossing Paths Intersection of Risk Adjustment and Coding 1 Objectives Define an outcome Define risk adjustment Describe risk adjustment measurement Discuss interactive scenarios 2 What is an Outcome?
More informationGuideline for the Referral of Patients to the Tissue Viability Service
Guideline for the Referral of Patients to the Tissue Viability Service Guideline for the Referral of Patients to the Tissue Viability Service Document Type Unique Identifier Document Purpose Document Author
More informationThe Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England
Report by the Comptroller and Auditor General The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England Ordered by the House of Commons to be printed 14 February 2000 LONDON:
More informationAWMA MODULE ACCREDITATION. Module Two: Pressure Injury Prevention and Management
AWMA MODULE ACCREDITATION Module Two: Pressure Injury Prevention and Management Introduction - The Australian Wound Management Association Education & Professional Development Sub Committee-(AWMA EPDSC)
More informationBackground and Issues. Aim of the Workshop Analysis Of Effectiveness And Costeffectiveness. Outline. Defining a Registry
Aim of the Workshop Analysis Of Effectiveness And Costeffectiveness In Patient Registries ISPOR 14th Annual International Meeting May, 2009 Provide practical guidance on suitable statistical approaches
More informationHow NICE clinical guidelines are developed
Issue date: January 2009 How NICE clinical guidelines are developed: an overview for stakeholders, the public and the NHS Fourth edition : an overview for stakeholders, the public and the NHS Fourth edition
More informationBest Practice Statement. Optimising wound care
Best Practice Statement Optimising wound care HealthComm UK Limited, trading as Wounds UK Limited, 2008 All rights reserved. No reproduction, copy or transmission of this publication may be made without
More informationEvidence based strategies for improving the clinical and economic outcomes of challenging wounds
Advanced Wound Management Expert Meetings 2017 - Challenging Wounds Programme Evidence based strategies for improving the clinical and economic outcomes of challenging wounds Invited Chair: Professor Gregory
More informationScottish Medicines Consortium. A Guide for Patient Group Partners
Scottish Medicines Consortium Advising on new medicines for Scotland www.scottishmedicines.org page 1 Acknowledgements Some of the information in this booklet is adapted from guidance produced by the HTAi
More informationThe clinical performance of a silicone foam in an NHS community trust. healthcare demand and resources by reducing economic growth.
The clinical performance of a silicone foam in an NHS community trust Jackie Stephen-Haynes, Alistair Bielby, Richard Searle The NHS spends the majority of its budget on labour costs and it could be argued
More informationFinal year student nurses experiences of learning about wound care: an evaluation
Final year student nurses experiences of learning about wound care: an evaluation Karen Ousey, Reader, School of Human and Health Sciences, Centre for Health and Social Care Research, University of Huddersfield,
More informationDownload or Read Online ebook wound care guidelines in PDF Format From The Best User Guide Database
Guidelines Free PDF ebook Download: Guidelines Download or Read Online ebook wound care guidelines in PDF Format From The Best User Guide Database and Skin Care Clinical Guidelines Chronic wound care must
More informationBOARD OF DIRECTORS PAPER COVER SHEET. Meeting Date: 1 st December 2010
BOARD OF DIRECTORS PAPER COVER SHEET Meeting Date: 1 st December 2010 Agenda Item: 9 Paper No: E Title: Management of Pressure Ulcers Purpose: For Information Summary: This paper provides a report on the
More informationPortfolio of Learning Opportunities: TISSUE VIABILTY PLACEMENT
Portfolio of Learning Opportunities: TISSUE VIABILTY PLACEMENT Information for Students Welcome to the placement. We hope that your placement will not only be educational, but enjoyable. During your placement
More informationDocument Author: Tissue Viability Nurse Date 15/02/2017
Guideline Title: Ref No: 1820 Version: 2 Document Author: Tissue Viability Nurse Date 15/02/2017 Ratified by: Care and Clinical Policies Group Date: 15/02/2017 Review date: 10 March 2019 Links to policies:
More informationHow effective is your pressure reducing surface?
How effective is your pressure reducing surface?...making it better Provides 24/7 data on pressure levels developing between patient and support surface. M.A.P monitor alert protect... Seeing is knowing...
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE 1 Guideline title SCOPE Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes 1.1 Short title Medicines
More informationSplit thickness skin grafts
Split thickness skin grafts This leaflet explains more about returning to your everyday activities after your split thickness skin graft. If you have any further questions, please speak to a doctor or
More informationApplying QIPP to Ageing skin
Applying QIPP to Ageing skin E45-UK-72-10 Dec 2010 Dr. Edward Vining PhD BPharm MRPharmS Applying QIPP to Ageing Skin Normal skin and barrier function Pathophysiology of ageing skin Complications Considerations
More informationCertified Skin & Wound Specialist Examination
Certified Skin & Wound Specialist Examination INSTRUCTIONS Please submit the following documents to the American Board of Wound Healing: 1. Signed Attestation Statement (See attached PDF) Confirming the
More informationTHE VIRTUAL WARD MANAGING THE CARE OF PATIENTS WITH CHRONIC (LONG-TERM) CONDITIONS IN THE COMMUNITY
THE VIRTUAL WARD MANAGING THE CARE OF PATIENTS WITH CHRONIC (LONG-TERM) CONDITIONS IN THE COMMUNITY An Economic Assessment of the South Eastern Trust Virtual Ward Introduction and Context Chronic (long-term)
More informationUsing ActivHeal in a traffic light system wound care formulary. Elizabeth Hawkins
Using ActivHeal in a traffic light system wound care formulary Despite recent announcement by the government that the NHS is safe from further budget cuts, there is still a responsibility to streamline
More informationDe-Feeting Wounds Regionally: Stepping into a Podiatry Led High Risk Foot Clinic
De-Feeting Wounds Regionally: Stepping into a Podiatry Led High Risk Foot Clinic The implementation of an Advanced Practice Role in Regional Allied Health Let us introduce ourselves Stacey Beacham Project
More informationThe South West Regional Wound Care Program (SWRWCP): A Collaborative Approach to Wound Care
The South West Regional Wound Care Program (SWRWCP): A Collaborative Approach to Wound Care 2017 OACCAC Conference June 15, 2017 #OACON17 I @OACCAC I @SWRWCP Disclosures None Objectives By the conclusion
More informationIndividuals with mental illness are at
Assessing and managing wounds in mental health settings KEY WORDS Content analysis Mental health nursing Tissue viability workshops Wound care Recently, there has been increasing emphasis on improving
More informationThe South West Regional Wound Care Program: A Collaborative Approach to Wound Care
The South West Regional Wound Care Program: A Collaborative Approach to Wound Care 2016 OACCAC Conference June 6, 2016 #OACON16 I @OACCAC I @SWRWCP Objectives By the end of this presentation, participants
More informationNHS. The guideline development process: an overview for stakeholders, the public and the NHS. National Institute for Health and Clinical Excellence
NHS National Institute for Health and Clinical Excellence Issue date: April 2007 The guideline development process: an overview for stakeholders, the public and the NHS Third edition The guideline development
More informationWound, Ostomy and Continence Nursing Certification Board (WOCNCB) Advanced Practice (AP) Wound Care Detailed Content Outline
Wound, Ostomy and Continence Nursing Certification Board (WOCNCB) Advanced Practice (AP) Wound Care Detailed Content Outline Content Code Description % of Exam 1 Domain 1: Comprehensive Assessment Items
More informationTHE USE OF MITTS (HAND CONTROL MITTENS) IN ADULT PATIENTS POLICY
THE USE OF MITTS (HAND CONTROL MITTENS) IN ADULT PATIENTS POLICY Policy Number: 171 Supercedes: Standards For Healthcare Services No/s 7, 10, 11, 14 and 16 Version No: Date Of Review: Reviewer Name: Completed
More informationSee the Pressure you re up against...
How effective is your pressure reducing surface? SEE THE PRESSURE DON T GUESS THE PRESSURE! Sidhil introduces M.A.P - the very first Continuous Bedside Pressure Monitoring System, which can be used on
More informationVanguard Programme: Acute Care Collaboration Value Proposition
Vanguard Programme: Acute Care Collaboration Value Proposition 2015-16 November 2015 Version: 1 30 November 2015 ACC Vanguard: Moorfields Eye Hospital Value Proposition 1 Contents Section Page Section
More informationWound, Ostomy and Continence Nursing Certification Board (WOCNCB) Advanced Practice (AP) Wound Care Detailed Content Outline
Wound, Ostomy and Continence Nursing Certification Board (WOCNCB) Advanced Practice (AP) Wound Care Detailed Content Outline Content Code Description Classification Items % of Exam 1 Domain 1: Comprehensive
More informationPressure Injuries. Care for Patients in All Settings
Pressure Injuries Care for Patients in All Settings Summary This quality standard focuses on care for people who have developed or are at risk of developing a pressure injury. The scope of the standard
More informationPolicies and Procedures. I.D. Number: 1038
Policies and Procedures Title: COMPRESSION BANDAGES- CARE OF I.D. Number: 1038 Authorization: [X] SHR Nursing Practice Committee Source: Nursing Date Effective: January 25, 2017 Scope: SHR & AFFILIATES
More informationWound Assessment and Product Selection
Wound Assessment and Product Selection Made Easy Denise Barton, BSN, RN, CWON Objectives Patient and Wound assessment. Tools to use when assessing a wound Documentation needed to direct treatment and supplies
More informationWhat you can do to help stop the spread of MRSA and other infections
MRSA wash it away As a patient it is important that you get better quickly and stay well. This leaflet gives you information about MRSA and other health care associated infections, so that you know what
More informationRisk Adjustment Methods in Value-Based Reimbursement Strategies
Paper 10621-2016 Risk Adjustment Methods in Value-Based Reimbursement Strategies ABSTRACT Daryl Wansink, PhD, Conifer Health Solutions, Inc. With the move to value-based benefit and reimbursement models,
More informationReduction of Surgical Site Infections in the Cesarean Section Patient through Incision Care
Problem: 1. Surgical site infections continued to remain higher than the NHSN (National Healthcare Safety Network) mean, despite implementation and compliance in all SCIP measures, up to and including
More informationCreating viable options
Creating viable options A tool for identifying key education content areas to support progressive development in tissue viability for health care staff July 2009 Creating viable options A tool for identifying
More informationEliminating Avoidable Pressure Ulcers. Professor Gerard Stansby
Eliminating Avoidable Pressure Ulcers Professor Gerard Stansby gerard.stansby@nuth.nhs.uk Why is this important? Important patient safety issue Pressure ulcers can be prevented (?All) Pressure ulcers are
More informationGUIDELINES FOR THE USE OF TOPICAL NEGATIVE PRESSURE (TNP) THERAPY IN WOUND MANAGEMENT
GUIDELINES FOR THE USE OF TOPICAL NEGATIVE PRESSURE (TNP) THERAPY IN WOUND MANAGEMENT Aim To provide evidence based principles in the use of Topical Negative Pressure therapy and management of patients
More informationCOMPANY BACKGROUND TYLER MEDICAL'S ROLE IN THE WOUND CARE COVERAGE ENVIRONMENT
6. COMPANY BACKGROUND Tyler Medical Supplies, Inc. is a nationwide provider of therapeutic wound care and surgical dressings to in need individuals with the necessary insurance coverage. Our current account
More informationGoing home with a redivac drain after surgery
Going home with a redivac drain after surgery This leaflet explains about going home with a redivac drain following your surgery. If you have any further questions, please speak to the nurse or doctor
More informationThe Registered Nurses Association of
Article Assessment and Management of Foot Ulcers for People with Diabetes: Second edition of RNAO s clinical practice guideline Citation: Bajnok I, Grinspun D, Lloyd M et al (2013) Assessment and Management
More informationFor more information about having an anaesthetic please see our leaflet, Having an anaesthetic - please ask a member of staff for a copy.
Forehead flap reconstruction If you have a wound on your nose after the removal of skin cancer, we may use the forehead flap reconstruction to repair your wound. This leaflet explains more about the procedure
More informationINTRODUCTION TO LOWER EXTREMITY WOUND PATHWAY TOOLS AND FORMS
INTRODUCTION TO LOWER EXTREMITY WOUND PATHWAY TOOLS AND FORMS Carolyn Morin: Enterostomal Therapy Nurse, Saskatchewan Health Authority Faye Street : Wound Resource Nurse, Saskatchewan Health Authority
More informationMy Discharge a proactive case management for discharging patients with dementia
Shine 2013 final report Project title My Discharge a proactive case management for discharging patients with dementia Organisation name Royal Free London NHS foundation rust Project completion: March 2014
More informationHealthcare associated infections across the health and social care community
Healthcare associated infections across the health and social care community Professor Brian Duerden CBE Inspector of Microbiology and Infection Control, Department of Health, London Infection is different..it
More informationHEALTHCARE ASSOCIATED INFECTION PREVENTION AND CONTROL REPORT JUNE 2016
Appendix--75 Borders NHS Board HEALTHCARE ASSOCIATED INFECTION PREVENTION AND CONTROL REPORT JUNE Aim The purpose of this paper is to update Board members of the current status of Healthcare Associated
More informationConnected Care. Theory vs. Reality. Joe Tracy. Vice President Connected Care and Innovation Lehigh Valley Health Network
Connected Care Theory vs. Reality Joe Tracy Vice President Connected Care and Innovation 2016 Lehigh Valley Health Network 5 Campuses 1 Children s Hospital 160 Physician Practices 17 Community Clinics
More informationJOB DESCRIPTION. Deputy Director of Nursing - Tissue Viability. Director of Nursing. Tissue Viability Support Tissue Viability Nurse
JOB DESCRIPTION Job Title: Reporting to (title): Tissue Viability Nurse Specialist Deputy Director of Nursing - Tissue Viability Professionally Accountable to (title): Responsible for Supervising (if appropriate):
More informationSCHEDULE 2 THE SERVICES
SCHEDULE 2 THE SERVICES A. Service Specifications Mandatory headings 1 4. Mandatory but detail for local determination and agreement Optional headings 5-7. Optional to use, detail for local determination
More informationPatient story. Pressure injury risk assessment vital to patient safety. Reducing harm from pressure injuries. June 2017
June 2017 Patient story Pressure injury risk assessment vital to patient safety Pressure injuries, also known as pressure ulcers or bed sores, are a major cause of preventable harm for patients using health
More informationQUESTIONS AND ANSWERS High Intensity Needs Fund Program Updated December 2, 2010
QUESTIONS AND ANSWERS High Intensity Needs Fund Program Updated December 2, 2010 1. Q: Is there a toll-free line? A: The Central HINF Team can be reached both by the free number: 1-877-353-HINF (4463)
More informationMEMORANDUM. Dr. Edward Chow, Health Commission President, and Members of the Health Commission
San Francisco Department of Public Health Barbara A. Garcia, MPA Director of Health City and County of San Francisco Edwin M. Lee Mayor MEMORANDUM DATE: May 31, 2017 TO: THROUGH: FROM: RE: Dr. Edward Chow,
More informationReducing MRSA bacteraemias associated with wounds. Heather Newton
Reducing MRSA bacteraemias associated with wounds Tackling healthcare-associated infections (HAIs) such as meticillin-resistant Staphylococcus aureus (MRSA) continues to be a key safety issue. As a result
More informationQuality Standards. Process and Methods Guide. October Quality Standards: Process and Methods Guide 0
Quality Standards Process and Methods Guide October 2016 Quality Standards: Process and Methods Guide 0 About This Guide This guide describes the principles, process, methods, and roles involved in selecting,
More informationQuality Improvement Scorecard March 2018
Mortality: HSMR Nat NB: Each month is a 12 month rolling value. I.e. Mar-16 reports the monthly average of Apr-15 to Mar-16. Performance further improved in October. November data not yet available. Mortality:
More informationHealing in Massachusetts:
Vol.8 Issue 5 May 2011 www.healthcareledger.com More People with Cancer Are Living Longer Elderspeak: Now Listen Honey! : B th rin e gi co n m gh f e y (4 o orta alt 1 3 ur b h ) 5 h le ca 62 om se re
More informationDoDNA WOUNDED, ILL, AND INJURED SENIOR OVERSIGHT COMMITTEE 4000 DEFENSE PENTAGON WASHINGTON, DC 20301
DoDNA WOUNDED, ILL, AND INJURED SENIOR OVERSIGHT COMMITTEE 4000 DEFENSE PENTAGON WASHINGTON, DC 20301 orc 1 0 2008 MEMORANDUM FOR SECRETARIES OF THE MILITARY DEPARTMENTS UNDERSECRETARY FOR HEALTH (VETERANS
More informationPreventing Cross-infection Patricia Folan and Lesley Baillie
CHAPTER 3 Preventing Cross-infection Patricia Folan and Lesley Baillie Preventing cross-infection is an essential activity for all nurses in their everyday practice. Nurses have an ethical and legal duty
More informationTRUST BOARD 22 December Nursing, Quality & Patient Experience Directorate. TISSUE VIABILITY Update and Ambition
TRUST BOARD 22 December 26 Nursing, Quality & Patient Experience Directorate TISSUE VIABILITY Update and Ambition Executive Summary The aim of the Tissue Viability Service is to provide specialist assessment
More information