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Community nurses perspectives and experiences of the community based on the ground education programme for managing chronic oedema/legulcers: a focus group evaluation / Tessa Watts
Swansea University Author: Watts, Tessa
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This report is a component of a larger study conducted by Swansea Centre for Health Economics, evaluating chronic oedema management in community settings. The aim of the project reported here was to evaluate the on the ground education programme from the perspective of community nursing staff who ca...
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This report is a component of a larger study conducted by Swansea Centre for Health Economics, evaluating chronic oedema management in community settings. The aim of the project reported here was to evaluate the on the ground education programme from the perspective of community nursing staff who care for people with chronic oedema/ leg ulcers. The ultimate goal of the education programme was to enhance community nurses’ of chronic oedema/leg ulcer prevention and management. Chronic oedema/leg ulcers have an enduring and profound, impact on the life quality of those who are affected by these conditions. Community nurses spend a considerable proportion of their time caring for people with chronic oedema/ leg ulcers (Chamanga et al. 2014, Benson et al. 2016). Additionally the conditions place an enormous burden on the National Health Service. As financial austerity continues and the prevalence of these conditions is projected to increase, it is essential that innovative, sustainable solutions in terms of prevention and safe, effective management are found so that positive outcomes for patients and clinical efficiency are optimised. The on the ground education programme for chronic oedema/leg ulcers was conceived and developed by Lymphoedema Network Wales. The intervention was designed to deliver education and support within community nurses’ workplaces, thereby reducing the need for study leave and enabling them to:•Effectively manage chronic oedema/leg ulcers through health technology applications with the right products being utilised at the right time;•Deliver care safely, reducing waste, harm and variation in prescribed treatments which are ineffective;•Reduce inefficient treatments and use of time.This evaluation was conducted over a short period of time at the end of 2016 and utilised a qualitative inductive approach. Data were generated from community nurses (n=12) within one University Health Board by means of focus group interviews (n=3). Participant anonymity was assured and has been preserved and promoted throughout this report. Every study will have methodological constraints and this small scale evaluation is no exception. The sample size is small, confined to one small area of Wales. Staff /caseload ratios were quite heterogeneous and covered disparate areas in terms of geography and the affluence-poverty nexus.The main findings indicated that the education programme had enhanced community nurses’ awareness, knowledge and understanding of chronic oedema management However, concerns were expressed about certain aspects of care promoted within the programme in terms of community nurses’ own professional practice and the conditions in which they operated. The community nurses did indicate that they thought by enhancing their knowledge base benefit might be conferred for patients in relation to the following: improved quality of life; self-efficacy and self-management. However, community nurses perceived that the magnitude of perceived benefit was variable and contingent on engagement with and support for self-management. Finally, while there was broad agreement that the underpinning idea of the intervention was positive, community nurses felt that there was considerable scope for improvement in terms of the intervention’s development and implementation and that long term sustainability of practice change was contingent on the presence of a lymphoedema specialist embedded within the locality to work with and across the different teams engaged in chronic oedema/leg ulcer care.
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