THE DEVELOPMENT OF NURSE LED LEG ULCER CLINICS IN PRIMARY CARE PUBLIC HEALTH NURSING SERVICE SLIGO/LEITRIM/WEST CAVAN CATRIONA 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