CMAJ • May 24, 2005; 172 (11). doi:10.1503/cmaj.1041441.
© 2005 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Harrison, M. B.
Right arrow Articles by Brandys, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Harrison, M. B.
Right arrow Articles by Brandys, T.
Related Collections
Right arrow Health services research
Right arrow Nursing (includes nurse practitioners)
Right arrow Community Medicine

Research
Recherche

Leg-ulcer care in the community, before and after implementation of an evidence-based service

Margaret B. Harrison, Ian D. Graham, Karen Lorimer, Elaine Friedberg, Tadeusz Pierscianowski and Tim Brandys

From the School of Nursing, Queen's University, Kingston, Ont. (Harrison, Friedberg); the School of Nursing (Graham), the Department of Medicine (Pierscianowski) and the Department of Surgery (Brandys), University of Ottawa; the Ottawa Health Research Institute, Clinical Epidemiology Program (Harrison, Friedberg, Graham); and the Victorian Order of Nurses (Lorimer), Ottawa, Ont.

Correspondence to: Margaret B. Harrison, School of Nursing, Queen's University, 78 Barrie St., Kingston ON K7L 3N6; fax 613 533-6331; harrisnm{at}post.queensu.ca

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 to $406 (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.




This article has been cited by other articles:


Home page
 CMAJHome page
M. B. Harrison, F. Legare, I. D. Graham, and B. Fervers
Adapting clinical practice guidelines to local context and assessing barriers to their use
Can. Med. Assoc. J., February 9, 2010; 182(2): E78 - E84.
[Full Text] [PDF]

Home page
 PERSPECT VASC SURG ENDOVASC THERHome page
D. D. I. Wright
The ESCHAR Trial: Should It Change Practice?
Perspectives in Vascular Surgery and Endovascular Therapy, June 1, 2009; 21(2): 69 - 72.
[Abstract] [PDF]

Home page
 BMJHome page
Minerva
BMJ, June 11, 2005; 330(7504): 1398 - 1398.
[Full Text] [PDF]

eLetters:

Read all eLetters

Care of Chronic leg ulcers, the problem of treating a surgical condition with medical means
Wah Ting Wong
CMAJ, 1 Jun 2005 [Full text]
No surgical panacea
Margaret B. Harrison
CMAJ, 28 Jul 2005 [Full text]
Surgical Verses Medical Management of Chronic "Venous" Leg Ulcers (Encouragement on Further Debate)
Wah Ting WONG
CMAJ, 17 Aug 2005 [Full text]