Journal of Community Nursing

18 / 24

18 JCN Supplement 2016
COMPRESSION THERAPY
that even the task of identifying
patients for the project was a strain
on the caseload manager. This
led to poor patient selection and
the temptation to quickly switch
patients back to compression
bandages. Furthermore, the nurse
tasked with leading the project left
during the data collection period,
resulting in difficulty in obtaining
all the information.
Also, although this project was
introduced to reduce the time
community nurses were spending
treating venous leg ulcers, it
was set-up during a period of
heightened staffing and resource
pressures, which made the process
harder to manage.
Project findings
Despite these issues and albeit
with a small sample, the project
demonstrated a significant time
saving in nurse visits, with two
patients (of the six who completed
the project) successfully discharged
to self-manage their condition. The
remaining four patients continued
to be treated by the community
nursing team with the adjustable
Velcro compression device as their
primary compression therapy
system. Using the juxtacures
product range, nurses were able to
empower patients to take control
of their treatment while improving
patient outcomes and reducing
costs (Elvin, 2015).
This project also offered local
practice nurses training and
education in alternative ways of
delivering compression therapy.
Due to the lack of practice
nurses who were competent in
compression bandages, as well as
introducing the devices into the
community wound care service,
it was also thought prudent to
include practice nurses in the roll-
out. Practice nurses often work in
isolation and are not always able to
attend venous leg ulcer treatment
updates. As a result, they do not
always possess the up-to-date
knowledge and skills to manage
these patients (Weller and Evans,
2012). The authors felt that the
juxtacures range offered a solution
to this, being simple to apply
with the built-in pressure system
allowing the nurse to accurately
monitor the level of compression
being applied to the limb to ensure
a therapeutic level was maintained
(Elvin, 2015).
CONCLUSION
The success of this project has
led to further plans to introduce
the juxtacures product range to
another large community nursing
team. This team has fewer nursing
vacancies and any agency nurses
are employed on a semi-permanent
basis, hopefully meaning that there
will be more continuity in the
project and that the pressures of
patient selection and nurse training
will be reduced.
In the future, the task of training
the service’s nurses — in particular
agency staff — and assessing their
competency to apply compression
therapy will continue. The authors’
team always try to look for ways to
provide education and training, not
only to improve patient outcomes
and ensure local guidelines are
adhered to, but also to invest in
agency nurses to demonstrate
that the service values its staff. It
is hoped that investing in agency
nurses in this way may lead to them
becoming permanent members of
the community nursing team at
some point.
Following this project, it is
hoped that the service will see
improved healing rates and
concordance with compression
therapy at the same time as
empowering those patients and
their carers who want to self-
manage their compression therapy.
This should result in cost savings
as well as freeing-up nurse time.
If these outcomes are achieved, as
they were in this project, the tissue
viability service can make a business
case to introduce the juxtacures
range as a first-line treatment
for venous leg ulcers and
chronic oedema. JCN
To cite this article: Freeman N, Norris R
(2016) Using an adjustable compression
system to treat community leg ulcers. J
Community Nurs 30(3): 47–52
REFERENCES
Curtis E, White P (2002) Resistance to
change: causes and solutions. Nurs
Manag 8(10): 15–20
Elvin S (2015) Cost efficacy of using Juxta
CURES and UCS debridement cloths. J
Comm Nurs 29(2): 62–5
Freeman N (2015) Enhancing a venous
leg ulcer treatment pathway with
compression wrap devices. Wounds UK
10(3): 60–5
Jones R (2007) Nursing Leadership and
Management: Theories Processes
and Practice. F.A. Davis Company,
Philadelphia
Lawrence G (2014) JuxtaCURES: an
innovative method of providing
compression for leg ulcer management.
Wounds UK 10(1): 64–70
Mosti G, Cavezzi A, Partsch H, Urson S,
Campana F (2015) Adjustable Velcro
compression devices are more effective
than inelastic bandages in reducing
venous edema in the initial treatment
phase: a randomized controlled trial.
Eur J Vasc Endovasc Surg 50(3): 368–74
Nelson E, Ruckley C, Barbenel J (1995)
Improvements in bandaging technique
following training. J Wound Care 4(4):
181–84
NHS England (2014) NHS Five Year
Forward View . Available online: www.
england.nhs.uk ) (accessed 18 April,
2016)
Partsch H, Mortimer P (2015) Compression
for leg wounds. Br J Dermatol 173:
359–69
Reynolds S (1999) The impact of a bandage
training programme. J Wound Care 8(2):
55–60
RCN (2015) RCN London Safe Staffing
Report 2015. Available online: .
org.uk (accessed 19 April, 2016)
Taylor A, Taylor R, Said S (1998) Using a
bandage pressure monitor as an aid in
improving bandaging skills. J Wound
Care 7(3): 131–3
Weller C, Evans S (2012) Venous leg ulcer
management in general practice —
practice nurses and evidence based
guidelines. Aust Fam Physician 41(5):
331–7
Wright S (2010) Dealing with resistance.
Nurs Stand 24(23): 18–20