District nurses’ experiences of caring for leg ulcers in accordance with clinical guidelines: a grounded theory study

Abstract

This qualitative study used the grounded theory method to investigate district nurses’ experiences of caring for leg ulcers in accordance with clinical guidelines at seven primary health care centres in Stockholm, Sweden. Group interviews were conducted with 30 nurses. The results describe how district nurses strive to stay on track in order to follow clinical guidelines and remain motivated despite prolonged wound treatment and feelings of hopelessness. Three main obstacles to following the guidelines were found. District nurses used compensating strategies so the obstacles would not lead to negative consequences. If the compensating strategies were insufficient, perceived prolonged wound treatment and feelings of hopelessness could result. District nurses then used motivating strategies to overcome these feelings of hopelessness. Sometimes, despite the motivating strategies, treatment in accordance with guidelines could not be achieved. With some patients, district nurses had to compromise and follow the guidelines as far as possible.

Custos Diretos Dos Curativos De Úlceras Vasculogênicas Realizados Por Uma Unidade De Tratamento Integral De Ferida

“…Em face do exposto, entende-se que os enfermeiros exercem papel fundamental no processo terapêutico dos pacientes com feridas crônicas. A sua capacitação para dar continuidade ao tratamento, bem como para seguir as diretrizes em relação às boas práticas à assistência nas feridas crônicas, é extremamente pertinente e poderá contribuir para a diminuição dos custos 28 . Além disso, propicia-lhes o alcance de melhores resultados de saúde, decorrentes da melhoria do apoio diagnóstico e da implementação de vias integradas de atendimento, tornando o processo terapêutico articulado e qualificado 1 , em relação àqueles atualmente observados com a terapia padrão.…”

Costos Directos De Las Curaciones De Úlceras Vasculogênicas Realizadas en Una Unidad De Tratamiento Integral De Heridas

“…Dado lo expuesto, se entiende que los enfermeros desempeñan un rol fundamental en el proceso terapéutico de los pacientes con heridas crónicas. Su capacitación para ofrecer continuidad del tratamiento, así como para seguir las pautas en relación a las buenas prácticas en el cuidado de heridas crónicas, es de suma relevancia y puede contribuir a la reducción de costos 28 . Además, les proporciona mejores resultados en salud, derivados de la mejora en el soporte diagnóstico y la implementación de vías de atención integral, articulando y calificando el proceso terapéutico 1 , en relación a los observados actualmente con la terapia estándar.…”

Direct Costs Corresponding to Vasculogenic Ulcer Dressings Performed in a Comprehensive Wound Care Unit

“…Given the above, it is understood that nurses play a fundamental role in the therapeutic process of patients with chronic wounds. Their training to provide treatment continuity, as well as to follow the guidelines in relation to the good practices in the care of chronic wounds, is extremely relevant and can contribute to the reduction of costs 28 . In addition to that, it provides them with better health outcomes, resulting from improved diagnostic support and from the implementation of integrated care paths, articulating and qualifying the therapeutic process 1 , in relation to those currently observed with the standard therapy.…”

“…To calculate for the VU dressings, US dollars (US$) were used considering a conversion rate of US$ 1.00/R$5 28. and based on the quotation on 09/18/2020, provided by the Central Bank of Brazil.…”