THE DEVELOPMENT OF NURSE LED
LEG ULCER CLINICS IN PRIMARY CARE
PUBLIC HEALTH NURSING
SERVICE
SLIGO/LEITRIM/WEST CAVAN
CATRIONA DUIGNAN, AADPHN
AIM OF INITIATIVE:

To develop Nurse Led Clinics for clients
with lower limb ulceration that require a
service which delivers the best care which
is evidence based and standardised with
improved patient outcomes
DRIVERS FOR ROLE
EXPANSION
NATIONAL

Venous leg ulcers prevalence = 0.12% in the adult
population increasing to 1.03% in > 70yrs
LOCAL

The Absence of Wound Management specialist
resources for 4 years

Establishment of Tissue Viability Nursing Service
Development Group (Integrated Services)
LOCAL
Point Prevalence Study (S/L/WC) ISA 2011:

46.5% of all wounds were Leg/Foot Ulcers (201 of 432)

79.1% of those were treated in the Community (159 of 201)

52% of the total wounds within the PHN Service were Leg/Foot
Ulcers (159 of 303)
Tissue Type/Dressing Audit (S/L/WC) PHN Service 2011:

43% of all wounds to be Leg/Foot Ulcers

Of 100 wounds 55.13% of wound management time was spent on
Leg/Foot ulcers (21hr 30mins) over a 1 week period
HOW?






Establishment of ‘Link Nurses’
Standardised referral pathways
Strengthen links with Podiatry,G.P’s,Practice
Nurses, Tissue Viability CNS and Vascular
Services
Strengthen links between hospital & primary care
services
Standardised documentation, assessment,
treatment and care bundles
Access/support education and training
DEVELOPMENT OF NEW SKILLS /
COMPETENCIES

Link Nursing Programme building capacity within
the service

Development of leadership skills

Teamwork - new working links across the ISA

Conduction of training needs analysis

PHN service as stakeholders inform education
and training initiatives
CHALLENGES AND SUPPORTS

‘National Best Practice and Evidence Based
Guidelines for Wound Management’ (HSE
2009)

Infrastructure/resources

Human resources

Staff motivation

Education and training

Clinical audit / evaluation
BENEFITS

More appropriate use of resources

Reduced Treatment times

Evidenced based care with improved
patient outcomes

Standardisation of care
THANK YOU FOR
LISTENING!

CATRIONA DUIGNAN, AADPHN
PUBLIC HEALTH NURSING
SERVICE

SLIGO/LEITRIM/WEST CAVAN