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Research article

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
CMAJ May 24, 2005 172 (11) 1447-1452; DOI: https://doi.org/10.1503/cmaj.1041441
Margaret B. Harrison
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Ian D. Graham
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Karen Lorimer
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Elaine Friedberg
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Tadeusz Pierscianowski
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Tim Brandys
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  • © 2005 CMA Media Inc. or its licensors

Abstract

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.

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Canadian Medical Association Journal: 172 (11)
CMAJ
Vol. 172, Issue 11
24 May 2005
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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, Tim Brandys
CMAJ May 2005, 172 (11) 1447-1452; DOI: 10.1503/cmaj.1041441

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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, Tim Brandys
CMAJ May 2005, 172 (11) 1447-1452; DOI: 10.1503/cmaj.1041441
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