Accelerating patient transitions from hospital to home in the United Kingdom with single-use negative pressure wound therapy: a discharge pathway.

Abstract

Background: Initially limited to inpatient use, negative pressure wound therapy (NPWT) is now frequently used in community settings. However, complexities in wound management step-down strategies in the United Kingdom, including regional variations in referral processes, lack of consensus on funding criteria, and limited availability of NPWT units, have led to extended hospital length of stay (LOS) for patients ready for discharge but still needing NPWT. Single-use NPWT (sNPWT) can serve as a bridge between hospital and community NPWT.

Objective: To assess the feasibility, effectiveness, and potential cost savings of the implementation of a discharge pathway utilizing sNPWT.

Methods: This case series included 5 patients with open lower limb wounds treated at a National Health Service facility using an sNPWT discharge pathway. Wounds were assessed before and after sNPWT use. Differences in average inpatient LOS and costs were calculated and compared with those for patients who remained hospitalized until community NPWT was available.

Results: The sNPWT discharge pathway was well tolerated by patients and resulted in good clinical outcomes. Patients discharged on sNPWT had an average reduction in LOS of 20.2 days, resulting in a projected £12 350 savings in hospital costs per patient.

Conclusion: Preliminary findings indicate use of an sNPWT discharge pathway is feasible and may result in reduced LOS and associated costs while improving patient care. Additional studies are needed to understand the effect on wound management, patient outcomes, and overall care costs.