Journal of Community Nursing (JCN) | April 2023

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Integrated care bundle for the management of chronic wounds

Integrated care bundle for the management of chronic wounds
Chronic wound

Pages: 38 - 44

Article topics: Community setting, Evidence-based practice, Integrated care

The aim of this retrospective, real-world cohort analysis was to explore the clinical and financial benefits following the implementation of integrated care bundles (ICBs) within a real-world cohort of multiple wound types across two large community care facilities in Ontario, Canada. An observational, retrospective cohort analysis of the effectiveness and safety of a series of wound-specific ICBs, adopted to improve the management of open chronic wounds, was undertaken. Outcomes from patients who received a multilayered,
silicone adhesive foam dressing as part of their ICB were compared with outcomes from patients who did not receive the ICB. Patients who received the ICBs, including treatment with the foam dressing (n=16,841), experienced improved outcomes compared with those who did not receive the ICB (n=2242), including a faster time to healing (12.8 vs 25.5 weeks, respectively), and longer time between dressing changes (3.5 vs 1.9 days, respectively). Decreased mean nursing visits in the ICB cohort led directly to reduced resource costs, compared with mean per patient costs in the non-ICB cohort (CAD$1733 vs $6488, respectively). It was found that the reality of delivering evidence-based best practice that is optimally placed to deliver good outcomes can be challenging. However, the authors’ experience suggests that the adoption of pathways and ICBs may
make it easier to adopt best practice.


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