Beyond hospital walls: patient and nurse perspectives on training and implementing venous leg ulcer care in the community.
Aims (1) To implement community-based compression bandaging for venous leg ulcer (VLU) patients using the Implementation Research Logic Model (IRLM) and train community nurses. (2) To evaluate patient and nurse perspectives on satisfaction, confidence and outcomes. Background In Singapore, compressi...
| Published in: | Journal of Wound Management Vol. 26; no. 3; pp. 164 - 175 |
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| Main Authors: | , , , , , |
| Format: | clinical trial research tables/charts Journal Article |
| Published: |
Cambridge Publishing
Nov2025
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189092393&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189092393 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27885771 MZEQ jtl: Journal of Wound Management issn: 27885771 maglogo: N pubinfo: dt: Nov2025 vid: 26 iid: 3 pid: 66266 pub: Cambridge Publishing artinfo: ui: 189092393 189092393 189092393 10.35279/jowm2025.26.03.07 189092393 ppf: 164 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Beyond hospital walls: patient and nurse perspectives on training and implementing venous leg ulcer care in the community. aug: au: </strong>, <strong>Author(s) Aloweni, Fazila Gunasegaran, Nanthakumahrie Goh, Wee Ting Saipollah, Hafidah Ang, Shin Yuh affil: Nursing Division, Singapore General Hospital, Singapore sug: subj: Community Health Nursing Education Program Implementation Venous Ulcer Nursing Elastic Bandages Utilization Education, Nursing, Continuing Patient Attitudes Nurse Attitudes Bandaging Techniques Education Patient Satisfaction Outcomes of Education Evaluation Community Health Nurses Education Human Funding Source Singapore Male Female Middle Age Aged Aged, 80 and Over Quasi-Experimental Studies Clinical Trials Implementation Science Tertiary Health Care Conceptual Framework Venous Ulcer Education Wound Care Education Referral and Consultation Social Work Continuity of Patient Care Self-Efficacy Workflow Compression Garments Supply and Distribution Skill Acquisition Confidence Competency Assessment Ambulation Aids Patient Compliance Comorbidity Hypertension Wound Healing Readmission Feedback Collaboration Cost Effectiveness Analysis Learning Environment Questionnaires Health Services Accessibility Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Aims (1) To implement community-based compression bandaging for venous leg ulcer (VLU) patients using the Implementation Research Logic Model (IRLM) and train community nurses. (2) To evaluate patient and nurse perspectives on satisfaction, confidence and outcomes. Background In Singapore, compression bandaging for VLUs has been limited to tertiary care due to inadequate community nurse training, therefore a structured program was developed to bridge this gap. Methods This quasi-experimental study evaluated the implementation outcomes of a structured training program on two and four layer compression bandaging in community settings. Patients were given the choice to receive compression bandaging in either community or tertiary care settings. The program included theoretical training, clinical attachments, and competency-based assessments. Guided by the IRLM, facilitators and barriers to community-based care were identified through multiple channels, including intervention characteristics, settings, processes, the referral system and experience by patients and nurses. Patient outcomes, training effectiveness and experiences were assessed after 12 weeks. Results 27 out of 47 patients opted for community-based bandaging; 15 completed follow-up, with nine achieving complete ulcer healing (median wound area reduction: -2.272 cm squared, p = 0.003). Patients reported consumable cost saving S$339.50 (median)and time savings to commute to the tertiary care centre. There was mixed confidence in the performance of community nurses. Fifteen community nurses completed the training, with half of them strongly supporting its utility. Discussion Community-based compression bandaging is feasible and effective in addressing VLU care gaps. It improves access, enhances outcomes and reduces costs through training and collaboration between tertiary and community teams. Conclusion and implications for nursing and/or health policy This initiative empowers community nurses with advanced skills and offers a scalable, cost-effective model to extend specialised care into the community. Aligning subsidy structures and decentralising healthcare supports equitable, sustainable care delivery and improved patient outcomes. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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