THE DEVELOPMENT OF NURSE LED LEG ULCER CLINICS IN PRIMARY CARE

PUBLIC HEALTH NURSING SERVICE

SLIGO/LEITRIM/WEST CAVANCATRIONA DUIGNAN, AADPHN

AIM OF INITIATIVE:

To develop Nurse Led Clinics for clients with lower limb ulceration that require a service which delivers the best care which is evidence based and standardised with improved patient outcomes

DRIVERS FOR ROLE EXPANSION

NATIONAL Venous leg ulcers prevalence = 0.12% in the adult

population increasing to 1.03% in > 70yrs

LOCAL The Absence of Wound Management specialist resources

for 4 years

Establishment of Tissue Viability Nursing Service

Development Group (Integrated Services)

LOCAL

Point Prevalence Study (S/L/WC) ISA 2011: 46.5% of all wounds were Leg/Foot Ulcers (201 of 432) 79.1% of those were treated in the Community (159 of 201) 52% of the total wounds within the PHN Service were Leg/Foot

Ulcers (159 of 303)

Tissue Type/Dressing Audit (S/L/WC) PHN Service 2011: 43% of all wounds to be Leg/Foot Ulcers Of 100 wounds 55.13% of wound management time was spent on

Leg/Foot ulcers (21hr 30mins) over a 1 week period

HOW?

Establishment of ‘Link Nurses’ Standardised referral pathways Strengthen links with Podiatry,G.P’s,Practice Nurses,

Tissue Viability CNS and Vascular Services Strengthen links between hospital & primary care services Standardised documentation, assessment, treatment and

care bundles Access/support education and training

DEVELOPMENT OF NEW SKILLS / COMPETENCIES

Link Nursing Programme building capacity within the service

Development of leadership skills

Teamwork - new working links across the ISA

Conduction of training needs analysis

PHN service as stakeholders inform education and training initiatives

CHALLENGES AND SUPPORTS

‘National Best Practice and Evidence Based Guidelines for Wound Management’ (HSE 2009)

Infrastructure/resources

Human resources

Staff motivation

Education and training Clinical audit / evaluation

BENEFITS

More appropriate use of resources

Reduced Treatment times

Evidenced based care with improved patient outcomes

Standardisation of care

THANK YOU FOR LISTENING!

CATRIONA DUIGNAN, AADPHN

PUBLIC HEALTH NURSING SERVICE

SLIGO/LEITRIM/WEST CAVAN