Standardisation through clinical audit: an example of good practice in leg ulcer management

Leg ulcers represent a considerable burden both financially and in health-related quality of life terms. Nurse-led clinics are the recommended model for service provision in leg ulcer management in Scottish Intercollegiate Guidelines Network (SIGN) 120: ‘Management of chronic venous leg ulcers’ (2010). However, despite comprehensive guidelines, inequities and shortfalls in leg ulcer service provision remain. As part of the ‘Releasing Time to Care’ national programme, a team of community nurses in NHS Greater Glasgow and Clyde applied clinical audit to assist in identifying areas for improvement at their busy leg ulcer clinic and utilised principles of lean methodology for the achievement of patient-centred leg ulcer management. Specific improvements included a reduction in patient waiting times, an improvement in nurses’ knowledge and skills in leg ulcer management, the standardisation of documentation and enhanced communication between members of the multidisciplinary team.