Tele-expertise assessment of chronic wounds by advanced practice dermatology nurses

Background The prevalence of chronic wounds continues to increase with the lengthening of life expectancy. The decreasing medical demography exacerbates a delay in care. Objective This study investigated the feasibility of evaluating chronic wounds through tele-expertise (TLE) by an advanced nurse practitioner (ANP) in dermatology. Methods We conducted a single-centre, observational study from November 2020 to May 2021. The main objective was to assess the ability of an Advanced Nurse Practitioner (ANP) to manage the orientation of care (medical or nursing) for requests for specialised advice on the treatment of chronic wounds through tele-expertise (TLE). The relevance of the advice provided by the ANP was evaluated by a dermatologist (D1). Simultaneously, a second dermatologist (D2) blindly determined what would have been the most appropriate care for the situation. His decisions were compared to those of the ANP using a Chi-2 test. Results Out of the 55 requests for teleconsultation to treat chronic wounds, the ANP considered that 43 (78.1%) cases required medical advice, while 12 (21.8%) could be managed within the scope of their expertise. D1 confirmed 72% of the ANP's decisions regarding cases deemed medical and 75% of cases deemed nursing by the ANP. Compared to the ANP's recommendations, D2 considered that 14 (25.5%) cases could be handled solely by the ANP, and 41 (74.5%) cases required a physician's intervention. Conclusion In teleconsultations for chronic wounds, a dermatologist confirms the orientation and care decisions made by a specialised ANP in approximately 75% of cases. This high level of agreement positions the ANP as a reliable partner in the wound care pathway in dermatology.