“as a newly qualified nurse, it also helped me to understandabout venous insufficiency.

I don’t feel so scared when I’m in the LU clinic” - CSN

“I often have no access toDoppler results in the patientshouse. If they have a passport I can see it before I applycompression” - SCN

2017

My Venous Leg Ulcer : Patient Passport Liz Ettridge, Tissue Viability Nurse, Tissue Viability and Wound Therapy Service, Medway Community Healthcare.

Introduction

The number of leg ulce

r patient in the UK con

tinues

to grow and with this

comes additional strain

on the

health service, both in

terms of capacity and

in

service provision (Gue

st et al 2017). Leg ulce

r care

may be carried out by

a range of clinicians i

n the

healthcare setting incl

uding leg ulcer specia

list

nurses, community nurs

es and practice nurse

s

(Guest et al 2017). Th

ere is also a need to

encourage patient em

powerment through b

etter

knowledge of their co

nditions and greater

involvement in their ow

n care as mentioned in

the

five year forward view

(NHS England 2015).

As is common in the U

K, the remit for care o

f

patients with leg ulcer

s at Medway Commun

ity

Healthcare (MCH) lies

within the community

nursing

service. This includes

running the leg ulcer c

linics

and seeing housebou

nd patients. The difficu

lty in

recruitment and reten

tion of community staf

f has

had an impact on lowe

r limb management wit

hin

Medway Community H

ealthcare. Tissue Viabi

lity

provide in house trainin

g aimed at new staff i

n order

to manage the issues

of staff education in le

g ulcer

management, howeve

r due to poor staff rete

ntion

there is a lack of exper

tise among communit

y

nurses.

MethodLocal Tissue Viability Teams have implemented Pathways ofCare for leg ulcers to help guide nurses, however, staffingproblems often meant leg ulcer clinics are staffed withinexperienced nurses who are not always confident to effectivelyeducate patients.

Often the only person in attendance at every visit is the patient,therefore there is a need to invest in patient education to fullyunderstand their leg problem and need for compression therapy,to enable full partnership in their management including theassessment process and plan of care. MCH have in the pastintroduced patient passports for pressure ulcers and cathetercare, to enable education and continuity of care between healthcare settings.

In order to address some of the issues mentioned above MCHdeveloped “My venous leg problem passport” which wasintroduced in similar way to those already in use.

The idea of the passport is to bring all the key elements ofpatient leg ulcer management together in one document.

The passport contains patient education, including the rationalefor the assessment, treatment options and aftercare. It isintended to enable the patient to have the understanding to takeownership of their chronic condition (expert patient). There isalso an area to document the Doppler result and compressiondetails and when and how to seek help. It is designed for thepatient to be able to fill in their own details, to prevent addedpressure on nursing time. The patient can show the passport toany health care professional in other settings, such as hospitaladmissions or while travelling, to give patient the confidence thattheir plan of care is being continued.

L&R have sponsored the idea, giving valuable advice andproduced laminated booklets the size of a passport.

Wounds UK, Harrogate 2017. This e-poster was kindly produced by L&R.

ResultsThe booklets

were first introduced to our

champion link

community nurses, while un

dertaking a level 6 lower limb

module in March 2017. The

y then promoted their use a

nd

cascaded to all community n

urses. On evaluation, they h

ave

proved very popular with pa

tients and staff, particularly i

n

the 4 leg ulcers clinics acros

s the organization. It is too e

arly

to see if has impacted of hea

ling rates.

'it really helped me to rememberwhat the nurse explained about

my leg problem.” - Patient

I know what treatment I’msupposed to have so can let thenew nurses know” - Patient

ConclusionThe booklets were first introduced to our champion linkcommunity nurses, while undertaking a level 6 lower limbmodule in March 2017. They then promoted their use andcascaded to all community nurses. On evaluation, they haveproved very popular with patients and staff, particularly inthe 4 leg ulcers clinics across the organization. It is too earlyto see if has impacted of healing rates.

“I love them, all my patients have them now and I often quiz

them on their knowledge”- Champion