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Evidence to Improve Care

Venous Leg Ulcers

Care for Patients in All Settings

Click below to see a list of brief quality statements and scroll down for more information.​​


Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence. ​

See below for the quality statements and click for more detail.​


Quality Statement 1: Screening for Peripheral Arterial Disease
People with a suspected venous leg ulcer are screened for peripheral arterial disease using the ankle-brachial pressure index (ABPI) or an alternative such as the toe-brachial pressure index (TBPI) if ABPI is not possible. Screening is conducted by a trained health care professional during the initial comprehensive assessment and at regular intervals (at least every 12 months) thereafter.


Quality Statement 2: Patient Education and Self-Management
People who have developed or are at risk of developing a venous leg ulcer, and their families or caregivers, are offered education about venous leg ulcers and who to contact for early intervention when needed.


Quality Statement 3: Comprehensive Assessment
People with a venous leg ulcer undergo a comprehensive assessment conducted by a health care professional trained in leg ulcer assessment and treatment, to determine the healing potential of the wound. This assessment informs the individualized care plan.


Quality Statement 4: Individualized Care Plan
People with a venous leg ulcer have a mutually agreed-upon individualized care plan that identifies patient-centred concerns and is reviewed and updated regularly.


Quality Statement 5: Compression Therapy
People who have developed or are at risk of developing a venous leg ulcer are offered compression therapy that is applied by a trained individual based on the results of the assessment and patient-centred goals of care.


Quality Statement 6: Wound Debridement
People with a venous leg ulcer have their wound debrided if it is determined as necessary in their assessment, and if it is not contraindicated. Debridement is carried out by a trained health care professional using an appropriate method.


Quality Statement 7: Local Infection Management
People with a venous leg ulcer and a local infection receive appropriate treatment, including antimicrobial and non-antimicrobial interventions.


Quality Statement 8: Deep/Surrounding Tissue Infection or Systemic Infection Management
People with a venous leg ulcer and a suspected deep/surrounding tissue infection or systemic infection receive urgent assessment (within 24 hours of initiation of care) and systemic antimicrobial treatment.


Quality Statement 9: Wound Moisture Management
People with a venous leg ulcer receive wound care that maintains the appropriate moisture balance or moisture reduction in the wound bed.


Quality Statement 10: Treatment with Pentoxifylline
People with large, slow-healing venous leg ulcers are assessed for appropriateness for pentoxifylline in combination with compression therapy.


Quality Statement 11: Referral to Specialist
People with a venous leg ulcer that is atypical, or that fails to heal and progress within 3 months despite optimal care, are referred to a specialist.


Quality Statement 12: Health Care Provider Training and Education
People who have developed or are at risk of developing a venous leg ulcer receive care from health care providers with training and education in the assessment and treatment of venous leg ulcers.


Quality Statement 13: Transitions in Care
People with a venous leg ulcer who transition between care settings have a team or provider who is accountable for coordination and communication to ensure the effective transfer of information related to their care.

13

Transitions in Care

People with a venous leg ulcer who transition between care settings have a team or provider who is accountable for coordination and communication to ensure the effective transfer of information related to their care.


Transitions in care involve changes in providers or locations (within and between care settings) and can increase the risk of errors and miscommunication related to a person’s care. To support coordination and continuity of care, transition planning should be collaborative, involving the person with the venous leg ulcer, their family, and their caregiver(s), and incorporating their individual concerns and preferences. To support the transfer of accurate information, all providers must document the most up-to-date information in the individualized care plan. A provider or team should be accountable for ensuring the accurate and timely transfer of information on an ongoing basis to the proper recipients as part of seamless, coordinated transitions.

For Patients

When you change health care settings (for example, you return home after being cared for in a hospital), your health care team or health care professional should work with you to make sure that important information is transferred with you, and that you are connected to the supports you need.


For Clinicians

Ensure that people moving between providers or care settings have a person or team responsible for coordinating their care and transferring information.


For Health Services

Ensure that systems, processes, and resources are in place to enable smooth transitions between care settings for people with a venous leg ulcer.

Process Indicators

Percentage of people with a venous leg ulcer who transition between care settings and have a team or provider who is accountable for coordination and communication to ensure the effective transfer of information related to their care

  • Denominator: number of people with a venous leg ulcer who transition between care settings

  • Numerator: number of people in the denominator who have a team or provider who is accountable for coordination and communication to ensure the effective transfer of information related to their care

  • Data source: local data collection


Percentage of people with a venous leg ulcer who transition between care settings and report that their team or provider knew about their medical history

  • Denominator: number of people with a venous leg ulcer who transition between care settings and answer the question, “During your most recent visit, did this team or provider seem to know about your medical history?”

  • Numerator: number of people in the denominator who answer “Yes”

  • Data source: local data collection


Percentage of people with a venous leg ulcer who transition between care settings and report that there was good communication about their care between their team and care providers

  • Denominator: number of people with a venous leg ulcer who transition between care settings and answer the question, “Do you feel that there was good communication about your care between your team, doctors, nurses, and other staff?”

  • Numerator: number of people in the denominator who answer “Usually” or “Always”

  • Data source: local data collection

Team or provider

This is the provider or team of providers who have an ongoing role in the coordination and delivery of health care services for the person who has developed a venous leg ulcer. Where possible, this should be a primary care provider or primary care team. Alternatively, an individual at the regional level who is responsible for care coordination could fill this role.

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