BACKGROUND: Leg ulcers usually occur in older patients, a growing population for which increasing health care resources are required. Treatment is mainly provided in patients' homes; however, patients often receive poorly integrated services in multiple settings. We report the results of a prospective study of a community-based care strategy for leg ulcers. METHODS: International practice recommendations and guidelines were adapted to make a new clinical protocol. The new model, for a dedicated service staffed by specially trained registered nurses, established initial and ongoing assessment time frames and provided enhanced linkages to medical specialists. Data were collected for 1 year before and after implementation; outcome measures included 3-month healing rates, quality of life and resource usage. RESULTS: Three-month healing rates more than doubled between the year before implementation (23% [18/78]) and the year afterward (56% [100/180]). The number of nursing visits per case declined, from a median of 37 to 25 (p = 0.041); the median supply cost per case was reduced from 1923 dollars to 406 dollars (p = 0.005). INTERPRETATION: Reorganization of care for people with leg ulcers was associated with improved healing and a more efficient use of nursing visits.
BACKGROUND:Leg ulcers usually occur in older patients, a growing population for which increasing health care resources are required. Treatment is mainly provided in patients' homes; however, patients often receive poorly integrated services in multiple settings. We report the results of a prospective study of a community-based care strategy for leg ulcers. METHODS: International practice recommendations and guidelines were adapted to make a new clinical protocol. The new model, for a dedicated service staffed by specially trained registered nurses, established initial and ongoing assessment time frames and provided enhanced linkages to medical specialists. Data were collected for 1 year before and after implementation; outcome measures included 3-month healing rates, quality of life and resource usage. RESULTS: Three-month healing rates more than doubled between the year before implementation (23% [18/78]) and the year afterward (56% [100/180]). The number of nursing visits per case declined, from a median of 37 to 25 (p = 0.041); the median supply cost per case was reduced from 1923 dollars to 406 dollars (p = 0.005). INTERPRETATION: Reorganization of care for people with leg ulcers was associated with improved healing and a more efficient use of nursing visits.
Authors: Ian D Graham; Margaret B Harrison; Karen Lorimer; Tadeusz Piercianowski; Elaine Friedberg; Maureen Buchanan; Connie Harris Journal: Adv Skin Wound Care Date: 2005 Jul-Aug Impact factor: 2.347
Authors: Rosana E Norman; Michelle Gibb; Anthony Dyer; Jennifer Prentice; Stephen Yelland; Qinglu Cheng; Peter A Lazzarini; Keryln Carville; Karen Innes-Walker; Kathleen Finlayson; Helen Edwards; Edward Burn; Nicholas Graves Journal: Int Wound J Date: 2015-12-03 Impact factor: 3.315
Authors: Helen Edwards; Kathleen Finlayson; Mary Courtney; Nick Graves; Michelle Gibb; Christina Parker Journal: BMC Health Serv Res Date: 2013-03-08 Impact factor: 2.655