Vanessa Harvey Vascular Clinical Nurse Specialist Current Leg Ulcer Management Challenges Patients not getting a differential diagnosis Lack of early treatment Current pathways are lengthy and sometimes delay treatment ID: 935164
Download Presentation The PPT/PDF document "Barriers to effective Leg Ulcer care" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Barriers to effective Leg Ulcer care
Vanessa Harvey
Vascular Clinical Nurse Specialist
Slide2Current Leg Ulcer Management Challenges
Patients not getting a differential diagnosis
Lack of early treatment
Current pathways are lengthy and sometimes delay treatment
Lack of surgical treatment awareness
Prevention of recurrence
Slide3c
56% of people with VLUs do not get a differential diagnosis Guest JF, et al (2015) Referral confusionVascular AssessmentABPI does not diagnose Venous diseasePractice NurseTVNPlastics
Derm
Vascular
District Nurse
Challenge of getting the diagnosis
?
?
?
?
Slide4Heading 28pt Calibri
Slide5Lack of early treatment and resources
Short on timeLocation of specialist clinicsAssociated treatment costsNurses trained in compression
Slide6Culture of current pathways
Franks, Barker et al. (2016) Management of Patients with VLUs.
Slide7Inequality of care
Surgical treatment options are not offered the same way everywhereVariations in support: from leg clubs to ulcer clinicsVariation in clinical nurse specialist support Access to information and surgical treatment options is limited for patients
Slide8Prevention of recurrence and MDT collaboration
Slide9To do this we needed a little TLC
2 years of pathway implementation and data collection to prove it worksTeam of motivated people who wanted to help those suffering from VLUsAttention to detail TimeLoveCare
Slide10Leg Ulcer Pathway Audit
Patients IdentifiedLarge cohort of patients suffering from VLUsTimely diagnostics and vascular assessmentABPI, Duplex ultrasound, MR Venogram or CT Venogram to check for superficial venous reflux & outflow obstruction, or arterial diseaseVascular AssessmentIncludes clinical, wound and quality of life assessmentsDifferential diagnosis with treatment planPossible surgical treatment options of stenting, superficial venous ablation, or compressionFollow up and wound management
Monitor wound
healing; complete quality of life assessment, stent patency checks
Slide11How we did this
1Industry collaboration Disease state mapping, project management assistance and funding support from Boston Scientific2Additional specialist nurseEmployed vascular clinical nurse specialist to implement pathway and run nurse led clinic
3
Stakeholder network
Strengthened relationships with local care teams and GSTT acute specialties
4
Collect and
analyse
data
Tracked patients along the pathway, with assistance of remote patient monitoring app, monitor healing rates and
QoL
.
Slide12Challenges to LUPA
Key challengesCapacityTechnologyOutpatient clinicsTheatreElectronic patient records
Medopad remote patient monitoring
Ultrasonic angiology
Slide13Goals
Quality of LifeWound healingPain
Improve Outcomes
Financial Savings
Slide14By delivering an optimal care pathway
the economic burden can be 10 times less, and the time to healing can be reduced from years to only a few months (Betty’s Story, 2017)