The Value of Nurses Specialized in Wound, Ostomy, and Continence: A Systematic Review

Abstract

OBJECTIVE To critically appraise peer-reviewed evidence concerning the value, or implied sense of worth or benefit, of nurses specialized in wound, ostomy, and continence (WOC) care. DATA SOURCES The Preferred Reporting Items for Systematic Reviews and Meta-analyses was used to systematically review current literature in a single database from 2009 to the date of search (July 2019). STUDY SELECTION The initial search retrieved 2,340 elements; 10 studies were retained following removal of duplicate records, title and abstract reviews, and application of the inclusion/exclusion criteria. DATA EXTRACTION Literature was graded and critiqued with regard to design and research quality and then synthesized using a narrative approach. DATA SYNTHESIS Nine values that WOC nurses demonstrate were identified: improved quality of life for patients, teaching and mentoring, cost reduction, improved efficiency, improved wound outcomes, improved incontinence outcomes, advanced treatments, research, and leadership. CONCLUSIONS Although current studies suggest that there is value in the WOC nurse role, in all areas of the trispecialty, there is a need for high-quality literature with higher-level designs focused on bias reduction.

Building a Business Case for Hiring Wound, Ostomy, and Continence Nurses

“…The publications reviewed were global and had varied practice settings, including hospitals, clinic, primary care, and the home. 7 Virginia Commonwealth University, a public academic hospital, demonstrated sustained reduction in HAPI rates and lower severity of HAPIs after implementing a comprehensive wound care team where most nurses were WOC nurses. 8 Increased HAPI severity is associated with increased inpatient mortality and readmission at 30, 60, and 90 days.…”

“…A systematic review of 10 articles published from 2009 to 2018 found that WOC nurses impact nine essential areas: quality of life, teaching and mentoring, cost reduction, improved efficiency, improved wound and continence outcomes, advanced treatments, research, and leadership. The publications reviewed were global and had varied practice settings, including hospitals, clinic, primary care, and the home 7 . Virginia Commonwealth University, a public academic hospital, demonstrated sustained reduction in HAPI rates and lower severity of HAPIs after implementing a comprehensive wound care team where most nurses were WOC nurses 8 .…”

Creating a Comprehensive Hospital-Based Skin and Wound Care Program to Improve Outcomes and Decrease Pressure Injuries

“…Researchers have found that having WOC nurses brings important elements of value to care and wound outcomes, including "improved quality of life for patients, teaching and mentoring, cost reduction, improved efficiency, improved wound outcomes, improved incontinence outcomes, advanced treatments, research, and leadership." 8 Two WOC NSs were present at the beginning of the project. They primarily saw inpatients and, on rare occasions, would see an outpatient, providing consultations and following up on complex cases.…”

“…Physician experts are part of the team, but wound care nurses are the “linchpins” connecting the direct care staff to recommendations for both preventive care and treatments. Researchers have found that having WOC nurses brings important elements of value to care and wound outcomes, including “improved quality of life for patients, teaching and mentoring, cost reduction, improved efficiency, improved wound outcomes, improved incontinence outcomes, advanced treatments, research, and leadership.” 8 …”

Getting Ready for Continence Certification

“…According to a systematic literature review,1 value added to the health care system by wound, ostomy, and continence (WOC) nurses includes teaching and mentoring, cost reduction, improved efficiency, improved wound outcomes, improved incontinence outcomes, advanced treatments, research, leadership, and quality of life (QoL). The most significant evidence for value added by WOC nurses was for QoL improvement and was further demonstrated through improved incontinence-specific outcomes.…”