Authors (including presenting author) :
Chung SP(1), Pun MK(1), Yeung CY(1), Chong HM(2), Leung PM(1)
Affiliation :
(1) Nursing Services Division, New Territories West Cluster, (2)Department of Surgery, New Territories west Cluster
Introduction :
Hospital-acquired skin tears / skin injuries present a distressing experience for both patients and the healthcare workforce. The occurrence of such related injuries has been increasing clinically, attributable to the expanding elderly demographic and the mounting complexity of medical circumstances. Thus, advancement in this particular area is undoubtedly requisite.
Objectives :
This economic evaluation intended to establish whether implementing a new skin tear management protocol in Tuen Mun Hospital is more economically viable.
Methodology :
A novel skin tear management strategy was introduced to the hospital's nursing team between January and June 2024. A retrospective contrast of the 6-month skin tear incidents before and after the execution was performed, with a focus on dressing consumable expenses, nursing costs, and wound healing durations, to conduct a cost-effectiveness assessment. The cost-effectiveness ratios (CER) were identified for comparison.
Result & Outcome :
61 patients and 82 patients were suffered from hospital-acquired skin tear 6-month before and after the implementation of the novel skin tear management strategy respectively from July to December 2023 and July to December 2024 in Tuen Mun Hospital in-patient settings. The novel skin tear management strategy obligated nursing staff to execute more refined nursing procedures by utilizing specialized dressing consumables during the initial management phase. That inevitably led to a surge in nursing time, increased from average 20 minutes to 45 minutes. The initial wound management cost had estimated 158.3% increment. However, the superior quality of nursing care was hypothesized to result in a lessening of subsequent wound infection/colonization and more favourable clinical consequences. Being beneficial to the reduced wound healing time and less frequent dressing change, the overall expenditures on dressing consumables and nursing time were curtailed. With a average 23.0% reduction in wound healing time under the new approach, the overall dressing consumable outlay and nursing cost diminished by 56.9% and 45.8%. The total average cost per patient was reduced by 49.3%, from HK$738.2 to HK$374.4. The cost-effectiveness ratio (CER) was reduced from HK$1.68 to HK$0.76 per minute of nursing time saved, that is, average 54.8% cost reduction to salvage each minute of nursing time in new management approach.
