Authors (including presenting author) :
Lau LW(1), Wong KL(1), Lo KY(1), Ip MK(1)
Affiliation :
(1) Commuity Nursing Services, Yan Chai Hospital
Introduction :
In 2024, Yan Chai Hospital Community Nursing Service (CNS) provided wound care to 1554 patients, with lower limb ulcers accounting for approximately 17% (493 of 2903 wounds). A Venous Leg Ulcers (VLU) is a common type of leg ulcer. Delays in treatment increase wound chronicity and patient suffering. VLU benefits from compression therapy, while arterial ulcers may require surgery or conservative management. Misapplication of treatments can lead to severe tissue damage. Ankle Brachial Index (ABI) assessment is crucial for the safe application of compression therapy by measuring arterial blood flow. A new automatic ABI device was issued to facilitate ABI measurement for leg ulcer patients. Based on the ABI result, Community Nurses (CNs) can apply timely compression therapy or other treatment.
Objectives :
Provide training to enhance CN’s knowledge and skills on utilization of automatic ABI device and management of potential VLU patients. Provide ABI assessment to chronic leg ulcer patients at home by trained CNs for timely and safe compression therapy for wound healing and improve their quality of life.
Methodology :
In 2023, working group in CNS was established for enhancing of leg ulcer patient’s management and seek advice from Nurse Consultant (NC), Wound & Stoma to standardized ‘Workflow for Leg Ulcer Management’. All CNs need achieved training program included talks on VLU assessment, interpretation of ABI results and compression therapy techniques. A series of guides were developed: Assessment Checklist of Suspected Venous Leg Ulcer and tailor-made video for demonstrations of the automatic ABI device with QR code. ABI interpretation Cue card using on automatic ABI device. CNs were required to achieve competency in ABI device use and skill on compression therapy through return demonstrations. Afterwards, CNs recruited potential VLU patients for early commencement of compression therapy through ABI assessments. Consultation with NC was advised if needed.
Result & Outcome :
From 2023 to now, CNs performed ABI assessments for 18 leg ulcers patients, mean age was 84 years. Mostly results are positive outcomes. 13 patients received compression therapy: 10 patients of wounds healed, 2 patients in progress and 1 patient refused. Additionally, 4 patients's suspected peripheral arterial disease (PAD) and 1 patient confirmed PAD were advised against compression therapy and seek medical advice. Moreover, 32 CNs passed the quiz, competence assessment in ABI device utilization and compression therapy. CNs highly appreciated the instruction guides and joint visit sessions for skill transfer. The enhancement program showed significant benefits to leg ulcer patients with appropriate treatment plan.
