Date of Award

Spring 2025

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

DNP

First Advisor

Cathleen Colleran

Second Advisor

Courtney Coffey

Abstract

BACKGROUND: Venous leg ulcers (VLUs) are the most common lower extremity ulcers, accounting for 75% of chronic leg wounds and affect up to 2% of the population in developing countries. Generally, it has a 1-year recurrence rate of 40-70%. VLUs costs about $11B in the USA and other developed countries annually. Patients with VLUs spend about $7,000 more annually. Compression therapy along with local wound care is the best approach for VLU management, with compression therapy as the gold standard. Currently, compression therapy is underutilized in VLU care. The goal of this QI project is to provide wound nurses who are tasked with applying compression therapy with resources necessary for improvement in VLU management utilizing optimized compression to produce faster healing rate.

METHODS: The theoretical domains framework (TDF) was used to understand wound nurses’ behavior regarding care of their VLU patients, and the Plan-Do-Study-Act was used in delivering the interventions and studying the outcomes. The intervention was education, provision of an algorithm, and at-the-elbow support for the wound nurses over a period of 8 weeks while providing care to eligible VLU patients. A pre and post intervention survey was used to assess changes in wound nurses’ behavior and percentage area reduction (PAR) was used to study the effect of optimized compression on patient’s wound outcomes.

RESULTS: Sample sizes were small for the patients and the wound nurses. There was improvement in wound healing among the patients with optimized compression and the nurses felt that the interventions were beneficial and have potential for adoption.

CONCLUSIONS: Optimized compression therapy applied by wound nurses given proper education and support resulted in faster wound healing in patients, but a small sample size precludes generalizability.

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