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Improving patient outcomes through the implementation of a person-centred leg ulcer pathway
Julie Mullings1, Elizabeth Merlin-Manton2
1Lead Nurse, Tissue Viability, Manchester Foundation Trust, Manchester, UK.
Objective:
To develop a holistic pathway for leg ulcer assessment and management, implemented within a local community organisation. The primary aim for this pathway was to reduce time-to-healing.
Method:
A leg ulcer pathway was designed to be used in all care settings to support continuity, and contains quality of life (QoL) assessment tools, a treatment algorithm, guidance for use, a leg ulcer assessment form, and a wound treatment chart.
Results:
Data analysis, carried out 12 months after implementation, compared pre- and post-averages for ulcer time-to-healing: 123.7 days (median: 84 days), n=46 pre-implementation, versus 69.1 days (median: 46 days), n=30 post-implementation, respectively, which demonstrated a minimum 44% reduction in time. Cost saving analysis demonstrated a minimum cost reduction of 45% in nursing time.
Conclusion:
The implementation of a structured, person-centred leg ulcer pathway has provided many benefits to patients, clinicians and the hospital and community trust. Enhancing correct dressing product placement by ensuring the right dressing is used at the right time, in tandem with the correct compression regime, improved healing outcomes. The patient journey has become more streamlined providing the best chance to achieve full healing quickly.
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