As leg ulcer management becomes increasingly complex, access to high quality, effective care is vital for timely healing of venous leg ulcers. In a recent article, I raised some of the key issues in clinical practice which impact on the Government’s vision of quality and equity in healthcare services as set out in the 2008 Darzi report (High Quality Care for All) and numerous subsequent publications from the Department of Health.
In the UK more than three per cent of the population is affected by leg ulceration and many more by chronic swelling of the lower limbs, known as chronic oedema. The main reason for ulceration is due to high pressure in the leg veins. Healing rates of venous leg ulcers which are relatively uncomplicated range from fifty to seventy per cent at 24 weeks and complicated ulcers take considerably longer, if they heal at all.
The main treatment is high pressure bandaging to reduce the venous pressure. Special training is necessary otherwise patients can be seriously damaged by the treatment. There are national guidelines for leg ulcer care but evidence suggests that patients often are not fully assessed and do not receive optimum care - at considerable cost to patient’s lives and health care services.
Most venous leg ulcer care is given by nurses, and better outcomes for patients are evident when the practitioner is knowledgeable about the condition and has sufficient skills to apply treatment safely and effectively. The Department of Health’s vision of quality and equity is only achievable if there is a focus on continuing professional development of healthcare staff and monitoring of the impact of such investment on patient outcomes.
The full article “Venous leg ulcers in context” was published in the July issue of Journal of Community Nursing.