title: Effectiveness of wound, ostomy and continence-certified nurses on individual patient outcomes in home health care.
abstract: OBJECTIVE
  To assess whether there was a significant improvement and stabilization (not worse at discharge) in pressure ulcers, lower extremity venous ulcers, surgical wounds, urinary incontinence, bowel incontinence, and urinary tract infections in home health care (HHC) patients cared for by a certified WOC nurse.
  
  
  METHODS
  There were 449,170 episodes of care from a national convenience sample of 785 HHC agencies with 447,309 nonmaternity, adult patients between October 1, 2008, and December 31, 2009.
  
  
  METHODS
  Descriptive and comparative.
  
  
  METHODS
  Data from the Outcome and Assessment Information Set documented by HHC clinicians were analyzed using mixed-effects logistic regression, propensity score analysis, and appropriate parametric and nonparametric tests. An Internet survey identified whether WOC nurses provided care to patients in an HHC agency. Home health care agencies identified records of patients receiving WOC nurse visits/consults.
  
  
  RESULTS
  An HHC patient assigned to a WOC nurse had surgical wounds, pressure ulcers, and incontinence problems that were significantly worse than HHC patients not assigned to a WOC nurse. Patients cared for by a WOC nurse showed significant improvement and stabilization of the number of pressure ulcers and surgical wounds and the frequency of urinary and bowel incontinence, despite having problems that were more severe than other patients. Home health care patients not cared for by WOC nurses, with less-severe wound and incontinence problems, also got better.
  
  
  CONCLUSIONS
  WOC nurses are effective in achieving positive health outcomes for pressure ulcers, surgical wounds, and incontinence in HHC patients with severe health problems.
authors: School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA. bliss@umn.edu
authors: Donna Z
authors: DZ
authors: Bliss
authors: Bonnie L
authors: BL
authors: Westra
authors: Kay
authors: K
authors: Savik
authors: Yuefeng
authors: Y
authors: Hou
mesh_terms: D017050:Episode of Care; D005242:Fecal Incontinence / Q000451:nursing*; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D010030:Ostomy / Q000451:nursing*; D017063:Outcome Assessment, Health Care; D003668:Pressure Ulcer / Q000451:nursing*; D011787:Quality of Health Care; D013041:Specialties, Nursing; D014549:Urinary Incontinence / Q000451:nursing*; D014552:Urinary Tract Infections / Q000451:nursing*; D014947:Wounds and Injuries / Q000451:nursing*