Singapore, 17 January 2023 — Since November 2022, patients with venous leg ulcers (VLU) have the option to change their compression bandage in the comfort of their homes instead of having to make weekly trips to Singapore General Hospital (SGH) to do so, thanks to a partnership with Home Nursing Foundation (HNF), a home healthcare non-profit organisation.
VLU are open sores caused by poor blood circulation in the leg veins. Those with varicose and spider veins, diabetes, obese individuals and the elderly, for instance, are at higher risk of developing them. The ulcer is often found near the ankle and may produce foul-smelling discharge.
Even though compression bandaging is the standard of care for VLU, some patients find the frequent visits to hospital a hassle and defaulted on their treatment. This may lead to severe infections and hospitalisation as a result.
To provide greater convenience to VLU patients, a team of SGH wound care, and vascular nurses developed and conducted a comprehensive Train-the-Trainer programme to equip community nurses with the necessary skills and techniques to perform different types of compression therapy.
“Our partnership with the Home Nursing Foundation ensures appropriate siting of care, as we identified a need to improve access to compression therapy among VLU patients. Many patients shared that the weekly travel is a hassle, especially for those with mobility issues and have no caregiver to assist with the commuting. The partnership with HNF helps to drive compliance to treatment and hence, better outcomes,” said Ms Fazila Aloweni, Senior Nurse Manager, Nursing Research, SGH.
Some 15 HNF community nurses went through the one-week programme at SGH between January and April 2021. It comprised of lessons on evidence-based wound management for vascular wounds, clinical attachment at SGH Diabetes & Metabolism Centre to observe and practice applying compression bandages on patients, and at the end of the programme, a competency assessment on their ability to do the bandaging independently.
Led by Ms Fazila, the team of SGH and HNF nurses then did a small comparison study from May 2021 to August 2022 to look at treatment outcomes of patients who had their compression therapy in SGH and by HNF in the community. Results showed that the care provided by HNF community nurses was as effective. The study was supported by the Agency for Science, Technology and Research (A*STAR) as part of the Wound Care Innovation for the Tropics (WCIT) Programme.
“We are strongly encouraged by the study results, and with this partnership, our nurses are also empowered with this new skillset in wound care. Moving forward, we plan to scale up this service with the training of our roster of community nurses in compression therapy to benefit more VLU patients,” said Ms Hafidah Binte Saipollah, Nurse Clinician, Wound, Ostomy and Continence Nursing, HNF.
SGH sees an average of 150 patients every week at its Diabetes & Metabolism Centre for compression therapy and wound care nurses spend an average of 30 to 40 minutes with each patient. The time saved from right-siting eligible VLU patients to HNF will allow SGH nurses to attend to patients with more complex needs.
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