Jeanne Widener
Marshall University, USA
Title: Venous leg ulcers: Impact on nursing of new practice guidelines
Biography
Biography: Jeanne Widener
Abstract
The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) published guidelines for the management of venous leg ulcers in August 2014. The goal of this presentation is to summarize the guidelines explaining how they may affect the nursing practice of vascular nurses. The epidemiology and financial impact of venous ulcers, anatomy and pathophysiology of venous leg ulcer development, clinical manifestations and prevention of venous leg ulcers will be briefly addressed to provide context for the diagnosis and treatment recommendations. The venous ulcer guideline committee included members from both the SVS and AVF and was further divided into 6 subcommittees to address diagnosis, compression issues, endovascular and surgical interventions, general wound care, ancillary treatments and preventative care. Each subcommittee was charged with evaluating the evidence available for quality and strength. The grading of recommendation assessment, development, and evaluation (GRADE) system (reported by the American College of Chest Physicians) was used by the committees to rate the evidence. High quality evidence received an A, moderate quality received a B and lesser quality received a C. Strong recommendations were assigned a 1 indicating greater benefit than harm. Suggestions were assigned a 2 indicating weak evidence of benefit or little difference in risk. Best practice is recommended when no research evidence is available or there is no alternative to that practice which must be provided. The GRADE scale includes 1A, 1B, 1C, 2A, 2B, 2C, and best practice.