Westra Bonnie L, Bliss Donna Z, Savik Kay, Hou Yuefeng, Borchert Andrew
Bonnie L. Westra, PhD, RN, FAAN, FACMI, Associate Professor, Director for the Center for Nursing Informatics, School of Nursing, University of Minnesota, Minneapolis. Donna Z. Bliss, PhD, RN, FAAN, FGSA, Alumni Foundation Research Professor, School of Nursing, University of Minnesota, Minneapolis. Kay Savik, MS, Senior Research Fellow, Office of Nursing Research, School of Nursing, University of Minnesota, Minneapolis. Yuefeng Hou, MS, PhD(c), Research Assistant, School of Nursing, University of Minnesota, Minneapolis. Andrew Borchert, Research Assistant, School of Nursing, University of Minnesota, Minneapolis.
Home Healthc Nurse. 2014 Feb;32(2):119-27. doi: 10.1097/NHH.0000000000000030.
The purpose of this study was to describe the prevalence, incidence, and effectiveness of home health care (HHC) agencies' services with and without a WOC nurse related to wounds, incontinence, and urinary tract infection (UTI) patient outcomes.
There were 449,243 episodes of care from a national convenience sample of 785 HHC agencies representing nonmaternity patients who were aged 18 years or older and receiving skilled home health services between October 1, 2008, and December 31, 2009.
This study employed descriptive and comparative designs for data collection and analysis. We analyzed data from HHC agencies' electronic health records and conducted an Internet-based survey of HHC agencies.
Data for this study were documented by HHC clinicians using the Outcome and Assessment Information Set. An Internet survey identified if a WOC nurse provided care or consultations within an HHC agency.
The majority of HHC agencies (88.5%) had some influence of a WOC nurse. The incidence of wounds, incontinence, and UTIs was higher for agencies with no WOC nurse. Home health care agencies with WOC nurses had significantly better improvement outcomes for pressure ulcers, lower extremity ulcers, surgical wounds, urinary incontinence, bowel incontinence, and UTIs as well as significantly better stabilization outcomes for these outcomes except lower extremity ulcers. Virtually all patients in HHC agencies with and without a WOC nurse had stabilization of their lower extremity ulcers.
Findings of this study suggest that influence of a WOC nurse is effective in achieving several important positive outcomes of HHC agencies' services for wounds, incontinence, and UTIs.
本研究旨在描述有无造口、伤口及失禁护理护士（WOC护士）的家庭健康护理（HHC）机构在伤口、失禁和尿路感染（UTI）患者结局方面的服务患病率、发病率及有效性。
从785家HHC机构的全国便利样本中选取了449,243次护理事件，这些机构代表年龄在18岁及以上的非产妇患者，他们在2008年10月1日至2009年12月31日期间接受专业家庭健康服务。
本研究采用描述性和比较性设计进行数据收集与分析。我们分析了HHC机构电子健康记录中的数据，并对HHC机构进行了基于互联网的调查。
本研究的数据由HHC临床医生使用结局与评估信息集记录。一项互联网调查确定了WOC护士是否在HHC机构内提供护理或咨询服务。
大多数HHC机构（88.5%）受到WOC护士的一定影响。没有WOC护士的机构中，伤口、失禁和UTI的发病率更高。有WOC护士的家庭健康护理机构在压疮、下肢溃疡、手术伤口、尿失禁、大便失禁和UTI方面的改善结局明显更好，除下肢溃疡外，这些结局的稳定结局也明显更好。实际上，有和没有WOC护士的HHC机构中的所有患者下肢溃疡都得到了稳定。
本研究结果表明，WOC护士的影响对于实现HHC机构在伤口、失禁和UTI服务方面的几个重要积极结局是有效的。
