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How a Certified Wound Care Nurse Improves Outcomes, Reduces Costs


Editor's note: We have partnered with The Wound Care Education Institute to raise awareness about the devastating effects of wound care knowledge gaps in the U.S. healthcare system. Our goal is to educate clinicians to empower themselves and their organizations to combat these gaps through wound care education.

Having a certified wound care nurse on staff makes a positive difference for both patient care and the bottom line.

Researchers have found reducing pressure injury rates saves money, with individual organizations that prevent even just one stage 3 or stage 4 pressure injury saving $20,000 in direct costs or up to $120,000 in total cost.

"In a vast majority of cases, pressure injuries are avoidable with the appropriate care," said Bob Applebaum, PhD, director of the Ohio Long-Term Care Research Project, professor in the Department of Sociology and Gerontology and a Scripps Research Fellow at Miami University.

This is important because more than 2.5 million people in the U.S. are affected by pressure injuries and more than 60,000 patients die each year as a direct result of the condition, according to the Agency for Healthcare Research and Quality.

The high cost of non-prevention

The average hospital treatment cost associated with stage 4 pressure injuries and related complications was $129,248 for hospital-acquired pressure injuries during one admission, and $124,327 for community-acquired pressure injuries over an average of four admissions. Pressure injuries cost $9.1 billion to $11.6 billion per year in the U.S., with the cost of individual patient care ranging from $20,900 to $151,700 per pressure injury. Medicare estimated in 2007 that each pressure injury added $43,180 in costs to a hospital stay, according to the Agency for Healthcare Research and Quality.

Value of a certified wound care nurse

Wound care certification is a boon to nursing careers, making enrollment in the Wound Care Education Institute (WCEI) an important component to your nursing expertise.

"Our alumni have made a commitment not only to their careers but also to their patients," said Diana Ramirez-Ripp, CWCMS, manager of live events with WCEI. "Some of our alumni go on to serve on boards of various organizations or open wound care centers. Once you become certified, you're considered an expert in your field, which can increase the likelihood of more professional opportunities."

A Centers for Medicare and Medicaid Services study was conducted following a 2016 wound care training of nearly 200 long-term care nurses in Ohio. The study found a connection between the presence of onsite wound care certified staff and a reduction in pressure injury rates for patients. A total of 199 nurses attended a face-to-face, five-day wound care certification course, and subsequently took the wound care certification exam offered by the credentialing board -- the National Alliance of Wound Care and Ostomy.

The Skin and Wound Management training was provided through WCEI as part of a joint venture with the Ohio Health Care Association and the Ohio Department of Medicaid. The goal was to determine whether measures related to pressure injury rates improved, as evidenced by a decrease in pressure injury rates for patients residing in skilled nursing facilities who employed certified wound care nurses.

In all, 140 nurses -- 70% -- passed the exam and became certified, according to John LeDell, CWCMS, client executive with WCEI, a Relias Healthcare company. "In addition to monitoring pressure injury rates, the other data collected on a routine basis was to confirm if the wound care certified nurse was still employed at each facility involved in the study," he said. "The tracking and reporting of data were done by the Ohio Health Care Association, and results were reported to the Ohio Department of Medicaid."

Proof of the benefits of certification

Once the training and examination process were complete, the study began and used fourth quarter 2016 as the baseline, followed by tracking high-risk pressure injury rates at Ohio skilled nursing facilities involved in the study, LeDell said. The Ohio Health Care Association divided the facilities involved in the study into two different groups, Group A and Group B. Group A facilities were those performing in the bottom 25% of pressure injury rates at baseline. Group B facilities were those performing in the top 75%. Key findings showed:

  • High-risk pressure injury rates decreased significantly for facilities that had certified wound care staff.
  • At baseline, Group A facilities had an 11.4% pressure injury rate in 2016, and saw that rate drop to 7% in 2017 -- an improvement of more than 4%.
  • Group B facilities who were already high performers with their quality measures, initially had a pressure injury rate of 3.61% in 2016, and saw their rate drop down even further to 3.2% in 2017.
  • Even more dramatic is the data for Group A when comparing the baseline rate in 2016 to 2018. Group A went from its starting rate of 11.4% in 2016 and dropped to 2.44% in 2018 -- close to a 9% drop.

"The results of this study are encouraging and a good first step as a pilot program on the topic," Applebaum said.

Learn more about why Wound Care Matters today.

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