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Development of a content-validated venous ulcer guideline
Laura Bolton1, Lisa Corbett, Laurie Bernato
1University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA. lbolton@gmail.com
Ostomy/Wound Management
|December 6, 2006
Summary
Evidence-based venous ulcer care guidelines exist, but inadequate reimbursement policies hinder their implementation in the US, delaying healing and increasing societal costs.
Area of Science:
- Wound Care
- Health Policy
- Evidence-Based Medicine
Background:
- Venous ulcers represent a significant healthcare burden.
- Evidence-based practice (EBP) in venous ulcer care can improve healing outcomes and reduce costs.
- The Association for the Advancement of Wound Care (AAWC) developed a guideline to support EBP.
Purpose of the Study:
- To develop a content-validated venous ulcer guideline based on the best available evidence.
- To identify barriers to the implementation of EBP for venous ulcers in the US healthcare system.
- To assess the impact of reimbursement policies on evidence-based venous ulcer care.
Main Methods:
- Systematic literature searches (MEDLINE, CINAHL, EMBASE) were conducted for venous ulcer algorithms.
- A multidisciplinary expert panel content-validated guideline elements using judgment quantification.
- An email survey of AAWC members (N=1,514) investigated the effects of reimbursement on EBP.
Main Results:
- A comprehensive Venous Ulcer Guideline was developed, incorporating A-level evidence and high Content Validity Index elements.
- Key barriers to implementing A-level evidence steps, such as sustained graduated compression, were identified.
- Inadequate and inconsistent reimbursement policies were found to impede the adoption of evidence-based practices.
Conclusions:
- Sufficient evidence supports improved venous ulcer care in the US.
- Reimbursement policies are a major impediment to quality, evidence-based venous ulcer practice.
- Addressing reimbursement issues is crucial to facilitate healing and reduce the societal burden of venous ulcers.
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