Bibliographic record
Abstract
PURPOSE: A Canadian specialty nursing association identified the necessity to examine the role and impact of Enterostomal Therapy (ET) nursing in Canada. A retrospective analysis of the cost-effectiveness and benefits of ET nurse-driven resources for the treatment of acute and chronic wounds in the community was undertaken. DESIGN: A multicenter retrospective pragmatic chart audit conducted a review of three nursing care models from four community nursing agencies and one company owned and operated by ET nurses. An analysis was completed utilizing quantitative methods to evaluate healing outcomes, nursing costs and cost-effectiveness. MAIN OUTCOME MEASURES: Kaplan Meier estimates were calculated to determine the average time to 100% healing of acute and chronic wounds and total costs in a community setting. Average direct nursing costs were determined by number of nursing visits and reimbursement for each visit. RESULTS: 496 charts were audited. An RN with ET or Advanced Wound Ostomy Skills (AWOS) was associated with lower overall costs: reduced time to 100% closure of the wound; and reduced number of nursing visits. Differences in health benefits and total costs between the ET/AWOS and hybrid nursing group was a reduction in healing time of 45 days and a cost difference of $5,927.00 per chronic wound. Increased ET/AWOS involvement demonstrated significant faster time to 100% closure at a lower mean cost. Differences in health benefits and total costs between the ET/AWOS and hybrid nursing group was a reduction in healing time of 95 days and an expected cost difference of $9,578.00 per acute wound. There was a significant difference in healing times and reduced mean cost as the ET/AWOS became more involved in the treatment. CONCLUSIONS: The greater involvement directly and indirectly by an ET/AWOS nurse in the management of wounds demonstrated greater savings and shorter healing times.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.064 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.029 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".