Strategies and approaches towards evidence-based practice in the management of chronic leg ulcers by nurses working in the community in Kronoberg County, Sweden and the East Riding & Hull, UK

Abstract

Aim: This paper reports one aspect of a study concerning management of chronic leg ulcers by nurses working in the community in Kronoberg County, Sweden (KC) and the East Riding & Hull, UK (ER). Our study focus was to describe reported evidence-based practice in leg ulcer care in two samples of nurses from two countries. The paper describes the overall utilisation of clinical guidelines and their use in clinical assessment, documentation and resource utilisation. Method: A semi-structured self-administered questionnaire was used. The questionnaire was sent to practising community nurses, nurses working in primary health care and nurses working in nursing homes. A total of 222 nurses working in KC, Sweden and 124 nurses in ER, UK (response rate 55% vs 50%) returned the questionnaire. Results: The results provide a rather mixed picture in relation to evidence-based practice. Whilst 60.3% of nurses in KC and 87.1% in ER use guidelines, the reported use of guidance on diagnostic investigations is much more variable both in terms of frequency and indication ( P=0.000). The widest difference was found in the use of cleansing agents: in KC 83.7% of nurses used tap water against 92.8% of nurses in ER who used a sodium chloride preparation ( P=0.000). Conclusion: This study provides information on the reported use of guidelines by the nurses in two different countries. It raises questions about the relationship between evidence and practice. Comparison between the two countries helps to expose the taken for granted expectations of practice.