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      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 Translated title: Comparison between the cost and the wound closure in a Clinical Management Unit that includes an Advanced Practice Nurse on Complex Chronic Wounds

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          Abstract

          RESUMEN Introducción: Las heridas de difícil cicatrización o complejas que aquejan a un alto porcentaje de la población, además de afectar a la calidad de vida de quien las padece, repercute en un alto coste económico, en tiempo de enfermería y en estancias hospitalarias. Objetivo: Conocer el coste económico, las heridas complicadas, el coste medio para el cierre y la media de días para el mismo que ha tenido cada profesional de enfermería comparado con la enfermera de práctica avanzada (EPA) en heridas crónicas complejas (HCC) de la Unidad. Metodología: Estudio descriptivo longitudinal del total de los informes de valoración de heridas generados desde la aplicación de heridas en DIRAYA (sistema de información asistencial corporativo para todo el Servicio Andaluz de Salud, historia de salud única de todos los episodios asistenciales del ciudadano) y que necesitaron materiales de cura en ambiente húmedo suministrados por la Unidad de Gestión Clínica (UGC). El estudio se desarrolló en la UGC de Algarrobo, perteneciente al Área de Gestión Sanitaria Este de Málaga-Axarquía, desde junio 2019 hasta junio 2020. Se trata de una muestra conceptual, ya que se ha incluido a toda la población de enfermeros y enfermeras de la UGC y las correspondientes hojas emitidas por ellos. Resultados: Durante el periodo de estudio se registraron un total de 416 heridas en la Unidad, de las cuales se cerraron 338, el 81,2%. La EPA trató el 22,6% del total de las heridas (94 heridas) y resolvió el 90,4% de ellas, siendo el coste medio para el cierre de las heridas de 21,3 €, en un plazo medio de 30,7 días, mientras que el resto de profesionales tuvo que tratar de media 32,2 heridas y se resolvieron de media el 76,7%, siendo el coste medio para el cierre de una herida de 36,2 € en un plazo medio de 172,1 días. Conclusiones: La introducción de la EPA en HCC en la UGC ha llevado a la Unidad a un mejor resultado en cuanto a gasto en materiales y al acortamiento de los días para la resolución de las heridas, lo que influye en una mejor calidad de vida para aquellos que las padecen. Además, la introducción de la EPA ha servido de revulsivo para los profesionales y les ha llevado a un mejor hacer en su trabajo con las heridas, lo que influye tanto en su autoestima profesional como en los pacientes a los que tratan.

          Translated abstract

          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.

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          Most cited references31

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          Human skin wounds: a major and snowballing threat to public health and the economy.

          ABSTRACT In the United States, chronic wounds affect 6.5 million patients. An estimated excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is rapidly growing due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from "highly branded" diseases such as diabetes and obesity. This seems to have overshadowed the significance of wounds per se as a major health problem. For example, NIH's Research Portfolio Online Reporting Tool (RePORT; http://report.nih.gov/), directed at providing access to estimates of funding for various disease conditions does list several rare diseases but does not list wounds. Forty million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also in homeland preparedness against natural disasters as well as against terrorism attacks. An additional burden of wound healing is the problem of skin scarring, a $12 billion annual market. The immense economic and social impact of wounds in our society calls for allocation of a higher level of attention and resources to understand biological mechanisms underlying cutaneous wound complications.
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            An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds

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              • Record: found
              • Abstract: not found
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              The humanistic and economic burden of chronic wounds: A systematic review

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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y Gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2021
                : 32
                : 3
                : 193-198
                Affiliations
                [2] Málaga orgnameÁrea de Gestión Sanitaria Este de Málaga-Axarquía España
                [1] Málaga orgnameÁrea de Gestión Sanitaria de Algarrobo. Este de Málaga-Axarquía orgdiv1Unidad de Gestión Clínica de Algarrobo España
                [3] Málaga orgnameÁrea de Gestión Sanitaria. Este de Málaga-Axarquía orgdiv1Unidad de Gestión Clínica Vélez-Norte España
                Article
                S1134-928X2021000400011 S1134-928X(21)03200300011
                3eb8721b-c687-4d5a-8981-eaaa664b7ab5

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 21 December 2020
                : 18 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 6
                Product

                SciELO Spain

                Categories
                Helcos

                Wound healing,costes,enfermera de práctica avanzada,heridas complejas,Cicatrización de lesiones,cost,advanced practice nursing,complicated wounds

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