P-86 Developing and implementing a community care pathway for the management of chronic oedema

Abstract

Background Chronic oedema has a profound impact on quality of life. It may originate from primary anatomical reasons (primary lymphoedema), be secondary to cardio-vascular dysfunction, be related to cancer or cancer treatments and is increasingly a result of obesity. The numbers of patients with chronic oedema are increasing and both specialist lymphoedema and community nursing teams are over-stretched. Many community nurses lack evidence-based knowledge and skills in the management of chronic oedema and specialist services therefore often provide care for both complex and straightforward management. Aims To develop and pilot an integrated community pathway for the management of chronic oedema. Method A Knowledge Transfer Partnership project was developed by 3M (Industry) with University of Nottingham. Clinical services in Leicester were engaged and an expert advisory group formed. A clinical care pathway was devised through Nominal Group technique. Data from a point prevalence study, across Leicester City was used to operationally define a feasibility assessment of the pathway. Implementation was supported by a competency framework and bespoke training programme. The pathway was piloted with 30 patients receiving care from three community nursing teams. Data collection: Quantitative and qualitative data has been collected via one-to-one interviews with the community nurses following appointments with pathway inducted patients. Such data includes; a consideration of the symptoms of oedema, a record of resource use, and questions pertaining to levels of patient and nurse knowledge. Results to date The pilot has been underway for three months and initial results reveal an improvement in symptoms supported by an immediate reduction in nurse visits and product use; alongside greater patient concordance.