The cost of wound care has been increasing annually, A high proportion of cost is atributed to dressing provision which locally is currently increasing at 3.2% per annum. An audit revealed costs associated with dressing provision within the community were :Delays in treatment due to waitng for prescriptons, inappropriate dressings were provided which resulted in wastage and inappropriate treatment, on formulary products being used resultng in increased cost and lack of clinical governance, Used dressings which are patient specific were being used Inappropriately. No real audit trail of where products were being used. To improve outcomes for patients and reduce costs an online non prescription ordering system (ONPOS) was introduced for wound dressings into community nursing ,cost savings for last year since implementation were £96,000. The web based ordering system allows the nurses to order dressings which are included in the formulary and is monitored by the wound care service
A project group which included the Clinical nurse specialist for wound healing, Procurement and medicines management was set up to explore the feasibility of rolling out the initiative into local nursing homes. A small funding grant was obtained to support the project which included an educational package to increase nurses knowledge of wound assessment and dressing selection. Three nursing Homes were initially invited to partcipate in the project which was then rolled out across the Locality.
Prior to implementation identfication of learning needs were established with nursing home managers and an audit of old stock was undertaken which revealed £10,178 of old stock that could not be used as they were prescribed for residence and were discontinued. If implemented across all nursing homes there could be a potential wastage identified of £254,450 of old stock. Following the delivery of educational package and implementation of ONPOS all nursing homes included in the pilot indicated that staff had increased knowledge in wound assessment and increase in confidence in delivering appropriate wound care
The success of the pilot project has led to the initiative being implemented in all nursing homes within the area to continue the improvement in patient outcomes and cost effectiveness. The ONPOS implementation has:
•Reduced waste and demonstrated cost savings
•Saved nursing time
•Improved patient care ensuring the right dressing is available in a timely manner
•Supports formulary compliance and clinical governance
•Provides audit information and allows greater understanding of dressing usage and assists in identifying areas where wound education may be required.