How effective is training in compression bandaging techniques?

The aim of this review was to investigate whether formalized compression bandage training is required for nurses to achieve compression bandaging of high quality, that is bandaging which produces sustained graduation from toe to knee. Medline, CINAHL and Embase databases were used in the search. Randomized controlled trials and quasi-experimental trials were included where (at a minimum) nurses experienced in compression bandaging had their skills reviewed before and after training, and then reviewed once more at a later follow-up session. Three studies matched these criteria. In all three, nurses in general did not achieve sustained graduated compression before training, despite being defined as experienced bandagers. There was a substantial improvement in bandaging skills immediately following training. Two trials found that this improvement was sustained for between 2 and 4 weeks. The results of the third study suggested that improvements might not be sustained in the longer term. This review raises issues for further research including the current standard of compression bandaging, by those individuals who consider themselves competent in this skill. In addition, there needs to be argument on how nurses' bandaging skills can be improved and maintained, including the depth of role of feedback. In the meantime, nurses need to be as diligent as possible in maintenance of their compression bandaging skills, and the training they give junior staff. The effectiveness of current training cannot be assessed by short-term improvements and must not be assumed.