Acute demand service: patterns of care and client outcomes
Funding body: Campbell Ballantyne Fellowship 2009, Nurse Maude Foundation. Project being undertaken in partnership with Pegasus Health, Christchurch.
Project description: This study involves a retrospective audit to investigate the variation in care and patient outcomes of patients treated in the community for cellulitis, and whether this variation can be explained by patient characteristics and factors related to care. It will examine aspects of the healthcare pathway and assess the relationship between variable-related outcomes, such as length of treatment , co-morbidities and hospitalisations. The audit may provide information on how and where patient outcomes can be improved, and identify barriers to care, whether it relates to treatment, access or self-care. Additionally there may be an increased understanding of the role of case management around the healthcare of specific client groups or populations (such as those living alone or with specific comorbidities). The data sources will be the patient’s health care records involving the routine collection of data required for that episode of acute illness.
Project update: The project commenced in January 2009 with a three month pilot audit of health records which identified the need for a better tool to record patient/treatment variables. Analysis of these records indicated patients who were obese or with other morbidities (e.g. diabetes, cardiac heart failure) were not healing at the same rate as other patients and requiring longer treatment of intravenous antibiotics. This was discussed with the Medical Director of Acute Demand service and the antibiotic dosage for cellulitis treatment was increased in obese patients. Collection of data began in March 2009 and was completed in March 2010. The data is being entered into SPSS for statistical analysis.
Project outcomes: Antibiotic dosage increased for obese patients based on the outcomes of the pilot audit.
National Care Management conference, Wellington, March 2009. Acute Nursing Care Team: an audit of case management and improvements to client outcomes. Presented by Sandi Evans.
4th International Community Health Nursing Research, August 2009. Clinical Audit as a means of validating or refuting nurses’ intuition about the efficacy of care options for patient s in the community with acute cellulitis. Presented by Sandi Evans and Chris Hendry
Ministry of Health (2009). Clinical Audit as a means of validating or refuting nurses’ intuition about the efficacy of care options for patient s in the community with acute cellulitis. Wellington: Author. Available from: www.moh.govt.nz
Further information: Lead researcher – Sandi Evans, Acute Demand Nurse, Nurse Maude
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