Dorman M C, Moffatt C J, Franks P J
Ostomy Wound Manage. 1995 Oct;41(9):34-42.
Leg ulcer care has largely been provided by community nursing staff in the UK. However, the treatment of leg ulcers has been accompanied by high cost and poor healing rates. As part of an initiative in a single district of the UK, six community leg ulcer clinics were established and a system of audits implemented to monitor their progress over two years. Improvements were demonstrated in the success of the patient referral system, correct assessment of patients with significant arterial leg disease, effective use of dressings, follow-up to prevent ulcer recurrence, improved nursing education in leg ulcer care, vastly improved healing rates during the first twelve weeks of treatment compared to patients in a pre-study audit, reduced pain and increase in the ability of patients to perform activities inside and outside the home, and a cost reduction from an estimated $680,000 per annum to $250,000 in the study district. The model of care implemented in these community clinics can be adapted to other communities. Priority must be given to auditing outcomes and changes to ensure that the most effective care is delivered in each community.
在英国，腿部溃疡护理主要由社区护理人员提供。然而，腿部溃疡的治疗成本高昂且愈合率低。作为英国一个单一地区倡议的一部分，设立了六个社区腿部溃疡诊所，并实施了审计系统，以监测其两年内的进展情况。结果表明，患者转诊系统的成功率、对患有严重腿部动脉疾病患者的正确评估、敷料的有效使用、预防溃疡复发的随访、腿部溃疡护理方面护理教育的改善、与研究前审计中的患者相比，治疗头十二周内愈合率大幅提高、疼痛减轻以及患者在家内外进行活动能力的增强，以及研究地区的成本从每年估计的68万美元降至25万美元。这些社区诊所实施的护理模式可适用于其他社区。必须优先对结果和变化进行审计，以确保在每个社区都能提供最有效的护理。
