Leg-ulcer care in the community, before and after implementation of an evidence-based service

Harrison, Margaret B.; Graham, Ian D.; Lorimer, Karen; Friedberg, Elaine; Pierscianowski, Tadeusz; Brandys, Tim
May 2005
CMAJ: Canadian Medical Association Journal;5/24/2005, Vol. 172 Issue 11, p1447
Academic Journal
Background: Leg ulcers usually occur in older patients, a growing population for which increasing health care resources are required. Treatment is mainly provided in patients' homes; however, patients often receive poorly integrated services in multiple settings. We report the results of a prospective study of a community-based care strategy for leg ulcers. Methods: International practice recommendations and guidelines were adapted to make a new clinical protocol. The new model, for a dedicated service staffed by specially trained registered nurses, established initial and ongoing assessment time frames and provided enhanced linkages to medical specialists. Data were collected for 1 year before and after implementation; outcome measures included 3-month healing rates, quality of life and resource usage. Results: Three-month healing rates more than doubled between the year before implementation (23% [18/78]) and the year afterward (56% [100/180]). The number of nursing visits per case declined, from a median of 37 to 25 ( p= 0.041); the median supply cost per case was reduced from $1923 to $406 ( p = 0.005). Interpretation: Reorganization of care for people with leg ulcers was associated with improved healing and a more efficient use of nursing visits.


Related Articles

  • Another lesson from Iraq. Peck, Richard L. // Nursing Homes: Long Term Care Management;May2004, Vol. 53 Issue 5, p6 

    Reflects on the nursing home in Baghdad, Iraq called Shamayea Nursing Home, which is the focus of Sylwia Kapuscinski's article. Number of residents it houses; Description of the facility; Reaction to the article.

  • Study suggests, but doesn't prove, negative PPS effect on quality. Edwards, Douglas J. // Nursing Homes: Long Term Care Management;Sep2004, Vol. 53 Issue 9, p20 

    Discusses the results of the study, "Effects of Medicare Payment Changes on Nursing Home Staffing and Deficiencies," featured in "Health Services Research," regarding the nursing home Prospective Payment System (PPS) and associated rate cuts on professional staffing levels in long-term care...

  • For whom the bell tolls. Hazelton, Lara // CMAJ: Canadian Medical Association Journal;8/17/2004, Vol. 171 Issue 4, p361 

    Presents an article about the experiences of a psychiatrist at a nursing home in Halifax, Nova Scotia. Description of the patients; Observations on rural nursing homes; Reflection on the concept of death.

  • Case-Finding for Depression in Elderly People: Balancing Ease of Administration With Validity in Varied Treatment Settings. Blank, Karen; Gruman, Cynthia; Robison, Julie T. // Journals of Gerontology Series A: Biological Sciences & Medical ;Apr2004, Vol. 59 Issue 4, p378 

    Background. Little is known about the performance of brief and ultrabrief (1- and 2-question) depression screens in older patients across varied treatment sites. This study (1) assesses their validity in clinics, hospitals, and nursing homes and (2) assesses cut-points for optimal clinical...

  • SENIOR SERVICE. Ogurek, Douglas; Nessler, Brenda // Health Facilities Management;May2005, Vol. 18 Issue 5, p28 

    Focuses on the design and furnishing of nursing homes and long-term care facilities. Background on the creation of homelike settings in senior living facilities in the 1940s and 1950s; Efforts of architects, designers and health facilities professionals in regaining the design concepts of the...

  • Let's Talk. Martin, Tracy // Indianapolis Monthly;Oct2015, Vol. 39 Issue 2, p98 

    The article presents suggestions on finding assisted living for aging parents. It is noted that discussing plans for a parent's future care should begin early to give parents more options to choose from. It is mentioned that the hopes, fears, and expectations that the others hold for the future...

  • Part four: Using reminiscence in residential homes. Housden, Sarah // Nursing & Residential Care;Apr2005, Vol. 7 Issue 4, p174 

    The article focuses on the reminiscence programme of Norfolk Adult Education in a residential home. The purpose of reminiscence programmes are discussed. The reminiscence programme of Norfolk is significant for both care workers and residents of a residential home. The factors to consider in...

  • CASE STUDY.  // Money Management;1/20/2005, Vol. 19 Issue 1, p21 

    The article informs that Mona, an aged pensioner, has been residing in a hostel for 18 months. Mona still owns her home, which is being rented. During this time, her home has been exempt under the assets test while the net rental income has been assessed under the income test. On June 30, 2004,...

  • Nursing Home Usage Declining….  // Journal of Financial Planning;May2007, Vol. 20 Issue 5, p12 

    The article discusses a report by the Lewin Group that reveals nursing home use is on the decline, despite the fact that people are living longer. An analysis of data from the National Nursing Home Survey reveals that the percentage of adults aged 65 years old and older who are living in nursing...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics