Evaluation of the introduction of the one stop clinic and dedicated nurses for the ulcer cruris venosum care in the east of the Netherlands

Abstract

Objective: In the Ziekenhuis Groep Twente (ZGT), a limited number of nurses from two community care organizations were trained by Dermatology nurses. These trained dedicated nurses visit the ulcer patients at home and give proper ulcer care. Furthermore the one stop clinic was introduced. The purpose of this study was to evaluate if there is a difference in time for wound healing for patients with UCV treated by dedicated nurses compared to treatment by nurses in the Dermatology outpatient clinic. Methods: In this retrospective cohort study all the files of patients with an ulcer in the Dermatology department of ZGT in Almelo and Hengelo between 1 June 2010 and 1 June 2015 were studied. Results: Out of a total of 385 new patients with an ulcer 97 patients were included. Patients who were treated by dedicated nurses were significant older (p=0.002) and had larger wounds (p=0.008). Age was not significantly related to time for wound closure (HR 0.99; 95 % CI: 0.97-1.01, p=0.226). After adjustment for confounders there was no significant difference in time for closure between dedicated nurses versus hospital care (HR 1.01; 95% CI: 0.61-1.67, p=0.961). The one stop clinic was statistically related to a shorter time of closure of the wound (p=0.009). The one stop clinic was also significant related to higher chance of wound closure (HR 1.94; 95% CI: 1.15-3.27, p=0.013). Conclusions: This study showed that the time to wound closure is not statistical different between patients treated by dedicated nurses compared to hospital care when adjusted for the effects of the one stop clinic. The one stop clinic gives a significant better chance for faster time of wound closure controlled for both groups.