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Nursing Best Practice Guideline
Indicator
Structure
Process
Outcome
Objectives
• To evaluate the supports
available in the organization
that allow for nurses to integrate
into their practice the
assessment and management
of venous leg ulcers.
• To evaluate the changes in
practice that lead towards
assessment and management
of venous leg ulcers.
• To evaluate the impact
of implementing the
recommendations.
Organization/Unit
• Review of best practice
recommendations by
organizational committee(s)
responsible for policies and
procedures.
• Availability of client education
resources that are consistent
with best practice
recommendations.
• Provision of accessible
resource people for nurses to
consult for ongoing support
during and after initial
implementation period.
• Development of forms or
documentation systems that
encourage documentation of
assessment and management
of venous leg ulcers.
• Concrete procedures for
making referrals to internal
and external resources and
services.
• Incorporation of assessment
and management of venous
leg ulcers in staff orientation
program.
• Referrals internally and
externally.
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Provider
• Percentage of nurses attending
the best practice guideline
education sessions on
assessment and management
of venous leg ulcers.
• Nurses’ self-assessed knowledge
of assessment and management
of venous leg ulcers.
• Nurses’ average self-reported
awareness levels of community
referral sources for clients
with venous leg ulcers.
• Evidence of documentation
in the client’s record
consistent with the guideline
recommendations:
a) Referral to the following
services or resources within
the community or within
the organization as necessary
– Wound Care Clinic,
Wound Care Specialist or
Enterostomal Nurse,
Dermatologist, Infectious
Disease Specialist, Vascular
Surgeon, Plastic Surgeon,
Family Physician,
Dietitian, Occupational
Therapist, Physiotherapist,
Chiropodist/Podiatrist,
Certified Compression
Stocking Fitter.
b) Provision of education and
support to client and family
members.
c) Client/family satisfaction.
Client
Eligibility criteria:
• new ulcer or
• recurrent venous
leg ulcer
Exclusion:
• arterial
• diabetic
• mixed
• primary
lymphadema
• vasculitis
• Percentage of clients admitted
to unit/facility or seen at the
clinic with venous leg ulcers.
• Percentage of clients with
venous leg ulcers who have
a Doppler assessment
completed and recorded by
a trained professional.
• Percentage of clients with
venous leg ulcers where
compression is appropriately
used.
• Percentage of clients adhering
to treatment plan at three
months post discharge.
• Percentage of clients reporting
reduced leg ulcer pain at three
months post discharge.
• Percentage of clients with
ulcers partially or fully healed
at three months post discharge.
• Percentage of clients accessing
referral sources in community.
• Percentage of clients seen or
to be seen for referral.
Financial Costs
• Cost related to equipment
and products (e.g., Doppler,
bandages).
• Cost related to implementing
guideline:
• Education and access to on
the job supports.
• New documentation systems.
• Support systems.
• Cost for treatments.