The clinical and service objectives for any leg ulcer service is to ensure effective delivery of care which is based on the best available evidence. To help achieve these objectives nursing standards/outcomes have been developed.
These standards/outcomes will enable the service to meet the domains of quality ensuring effectiveness of care, patient safety and a positive patient experience. These standards support some of the quality and safety outcomes as identified by the Care Quality Commission 2010.
The standards/outcomes are as follows
All patients with a non-healing lower leg wound of 2-4 weeks duration should have a full holistic leg ulcer assessment including a Doppler.
Patients should receive verbal and written information regarding their leg ulcer at the first assessment and ongoing as part of the care delivery so that they can be involved in the planning of care and encourage concordance in the implementation of care.
Patients consent and receive appropriate treatment that reflects their assessment and ulcer aetiology which is endorsed by national guidelines and support best and safe practice.
Leg ulcer assessment and treatment to be carried out by Professional staff trained and competent in leg ulcer management and the equipment that directly relates to the assessment, using the appropriate local documentation.
Organisations are required to have the appropriate standards/ clinical guidelines, training programmes and competency frameworks in place.
Patients in compression therapy are reviewed formally 3-6 monthly with assessment and Doppler, this is recorded in the patients clinical notes.
Patients with active ulcers have their care formally reviewed monthly (or sooner if there is evidence of deterioration) using the appropriate local documentation.
Demonstrate that ulcer recurrence is monitored and measures for prevention of recurrence endorsed by national guidelines are demonstrated.
Measure, monitor and record venous leg ulcer healing rates quarterly.
The template for these Nursing Standards have been based on the National Institute for Health and Clinical Excellence (NICE) Quality Standards.
These standards were initially devised by Nicola Whayman on behalf of the LUF and were then developed further through focus groups with practitioners throughout the UK.