护理师主导的伤口诊所对资源不足人群的影响:一项回顾性研究。

IF 1.6 4区 医学
Tuba Sengul, Dilek Yilmaz Akyaz, Oleg Teleten, Jeff Souza, Holly Kirkland-Kyhn
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引用次数: 0

摘要

背景:由于获得护理的机会有限、社会决定因素和未治疗的合并症,慢性伤口是一个重大的卫生保健负担,特别是在资源不足的人群中。这些因素导致愈合延迟、并发症、生活质量下降和费用增加。目的:本研究调查了在护士领导(np领导)伤口护理诊所治疗的资源不足个体的慢性伤口类型、护理障碍和临床结果,为改善可及性和连续性提供有针对性的干预措施。方法:这项回顾性队列研究分析了2020年至2024年间在西海岸一家np领导的诊所接受治疗的493名患者的医疗记录,重点关注伤口类型、护理障碍和临床结果。结果:非压迫性慢性溃疡(17.6%)和压迫性损伤(16.6%)是最常见的诊断,以下肢为主要部位(20.49%)。就诊次数与随访有很强的相关性(r = 1.0)。转诊来源与就诊状况无显著相关(χ2 = 2.67, p = 0.26)。总体而言,91.9%的伤口愈合,而16.8%的患者经历了持续的伤口问题,反映了诸如无法进入(17%)和拒绝护理(5.7%)等障碍。结论:np主导的伤口诊所对资源不足的人群至关重要,但在患者随访和参与方面面临系统性挑战。调查结果强调需要采取干预措施,改善连续性,并制定解决保健和社会决定因素的战略。意义:通过远程监测、社区推广和量身定制的方法来增强连续性、培养患者信任和解决社会决定因素,对于优化资源不足的慢性伤口患者的预后至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of nurse practitioner-led wound clinic for under-resourced populations: A retrospective study.

Background: Chronic wounds represent a significant health care burden, particularly among under-resourced people, due to limited access to care, social determinants, and untreated comorbidities. These factors contribute to delayed healing, complications, reduced quality of life, and increased costs.

Purpose: This study examined the types of chronic wounds, barriers to care, and clinical outcomes among under-resourced individuals treated at a nurse practitioner-led (NP-led) wound care clinic, to inform targeted interventions for improving access and continuity.

Methodology: This retrospective cohort study analyzed medical records of 493 patients treated at a NP-led clinic on the west coast between 2020 and 2024, focusing on wound types, care barriers, and clinical outcomes.

Results: The most common diagnoses were nonpressure chronic ulcers (17.6%) and pressure injuries (16.6%), with lower extremities as the main location (20.49%). A strong correlation was found between number of appointments and follow-up (r = 1.0). No significant relationship was seen between referral source and clinic visit status (χ2 = 2.67, p = .26). Overall, 91.9% of wounds healed, whereas 16.8% of patients experienced persistent wound issues, reflecting barriers such as inaccessibility (17%) and refusal of care (5.7%).

Conclusions: NP-led wound clinics are essential for under-resourced populations but face systemic challenges in patient follow-up and engagement. Findings highlight the need for interventions, improved continuity, and strategies addressing health care and social determinants.

Implications: Enhancing continuity, fostering patient trust, and addressing social determinants through remote monitoring, community outreach, and tailored approaches are vital to optimize outcomes for under-resourced individuals with chronic wounds.

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来源期刊
自引率
16.70%
发文量
172
期刊介绍: The Journal of the American Association of Nurse Practitioners (JAANP) is a monthly peer-reviewed professional journal that serves as the official publication of the American Association of Nurse Practitioners. Published since 1989, the JAANP provides a strong clinical focus with articles related to primary, secondary, and tertiary care, nurse practitioner education, health policy, ethics and ethical issues, and health care delivery. The journal publishes original research, integrative/comprehensive reviews, case studies, a variety of topics in clinical practice, and theory-based articles related to patient and professional education. Although the majority of nurse practitioners function in primary care, there is an increasing focus on the provision of care across all types of systems from acute to long-term care settings.
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