Bandage pressure measurement and training: simple interventions to improve efficacy in compression bandaging

Compression bandaging is a major cornerstone in the treatment of chronic venous insufficiency. Its efficacy considerably depends on the applied pressure and it is therefore largely dependent on the individual applying the system. The sub-bandage pressure was measured under three consecutive compression bandages applied by 21 nurses before and after training and the introduction of a pressure monitor (Kikuhime, MediTrade, Denmark). A questionnaire was used to evaluate the self-rating before and after the intervention. Before intervention, a questionnaire showed the confidence of the nurses in reaching sufficient sub-bandage pressure levels. However, 34.9% of all bandages were shown to be insufficient before intervention (< 20 or > or = 60 mmHg) and only 17.5% after intervention, representing a statistically significant improvement through intervention. Of the insufficient bandages, 77.3% were applied by nurses with more than 10 years of working experience. Furthermore, the mean sub-bandage pressure in active standing position, a marker for the working pressure, was improved form 38.7 to 64.3 mmHg after intervention. Continuous awareness and training are necessary to maintain sufficient compression bandaging. The availability of a pressure monitor was helpful to reach this goal. Long work experience and self-rating alone is not sufficient to maintain adequate quality in compression bandaging.