Background: To overcome the shortage of medical care delivery in the rapidly aging Japanese society, the Ministry\nof Health, Labour and Welfare in 2010 started to train the nurses to be able to conduct the specified medical acts.\nThe Japanese Nursing Association conducted the educational program to train the wound, ostomy, and continence\nnurses for the specified medical act of wound care. However, the difference between wound, ostomy, and\ncontinence nurses who conducted the medical act and those who did not was not clear. The aim of this study was\nto determine how trained wound, ostomy, and continence nurses spend their time during their entire shift in an\nacute hospital setting.\nMethods: In this prospective observational study, we selected those wound, ostomy, and continence nurses who\nreceived advanced training in the wound management program (T-WN) in 2011ââ?¬â??2012. Wound, ostomy, and\ncontinence nurses who did not receive the training (N-WN) were also recruited as controls. We conducted a time\nand motion study during subject's day shifts for 1 week. We calculated the time spent on tasks based on a task\nclassification code that was created to facilitate a two-group comparison.\nResults: Six T-WNs and five N-WNs were our analysis subjects. T-WNs spent significantly more time on direct\ncare than did N-WNs (p = 0.00). Moreover, in the sub-categories s of direct care, T-WN spent significantly more time on\nââ?¬Å?treatmentââ?¬Â than did N-WN (p = 0.01). T-WN spent significantly more time on treatment with (p = 0.03) or without (p =0.\n01) physicians than did N-WN. In the treatment activities, T-WN performed significantly more time on foot care (p = 0.01),\nwound cleansing (p = 0.01) and conservative sharp wound debridement (p = 0.01) than did N-WN. Frequencies of direct\ncare interventions for the patients was significantly different between T-WN and N-WN (p = 0.04).\nConclusions: T-WNs frequently engaged in direct care provided treatment for patients with chronic wounds.
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