DCW102-Leg Ulcer Management and Prevention Policy
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Leg Ulcer Management and Prevention Policy
1. Purpose
The purpose of this policy is to ensure that {{org_field_name}} provides effective, evidence-based leg ulcer management and prevention for service users. Leg ulcers are chronic wounds that require specialist care to prevent infection, promote healing, and reduce recurrence. This policy ensures compliance with the Regulation and Inspection of Social Care (Wales) Act 2016, National Institute for Health and Care Excellence (NICE) guidelines, and Care Inspectorate Wales (CIW) best practices.
Leg ulcers can significantly impact an individual’s mobility, quality of life, and overall well-being. This policy ensures that care staff identify risks early, implement appropriate preventative measures, and manage ulcers efficiently in collaboration with healthcare professionals.
2. Scope
This policy applies to: All care staff, including support workers, nurses, and managers, who assist with leg ulcer prevention and care. Service users at risk of developing leg ulcers or those currently receiving treatment. Healthcare professionals, including district nurses and tissue viability specialists, who collaborate in leg ulcer care.
It covers: Risk assessment and early identification of leg ulcers. Preventative measures to reduce ulcer development. Best practices in wound care and dressing application. Infection control and hygiene procedures. Coordination with healthcare professionals. Staff training and competency in leg ulcer care.
3. Principles of Leg Ulcer Management and Prevention
3.1 Risk Assessment and Early Identification
Early identification of risk factors is essential to prevent the development of leg ulcers. Care staff must conduct regular skin and vascular assessments for service users who are at higher risk, including those with: Poor circulation (venous or arterial disease). Diabetes, which increases the risk of ulcers and slow healing. Limited mobility or prolonged periods of sitting/bed rest. History of deep vein thrombosis (DVT) or blood clots. Obesity, which can impact circulation. Skin conditions such as eczema, dermatitis, or cellulitis.
Each service user must undergo a leg ulcer risk assessment as part of their initial care plan. If a service user has existing wounds or venous insufficiency, a detailed wound care plan must be implemented in collaboration with a district nurse or tissue viability specialist.
3.2 Preventative Measures for Leg Ulcers
To prevent the development of leg ulcers, {{org_field_name}} follows best practices, including: Encouraging good circulation through gentle movement and leg elevation. Supporting the use of prescribed compression therapy where appropriate. Promoting skin hydration using emollients to prevent dryness and cracking. Ensuring service users wear suitable footwear and clothing to prevent pressure damage. Assisting with healthy lifestyle choices, including smoking cessation and a balanced diet to promote skin integrity.
Care staff must encourage mobility where possible, as prolonged immobility increases the risk of venous stasis and ulcer formation. If a service user has limited mobility, repositioning techniques must be used to reduce pressure on high-risk areas such as the heels and lower legs.
3.3 Best Practices in Leg Ulcer Wound Care
If a service user develops a leg ulcer, care must be evidence-based, person-centred, and delivered in collaboration with healthcare professionals. The following best practices must be followed:
- Accurate wound assessment: Care staff must observe and document the size, depth, colour, and exudate levels of the wound, reporting changes immediately to healthcare professionals.
- Appropriate dressing selection: The choice of dressing is determined by the nurse or clinician, based on the type of ulcer, infection risk, and exudate level. Staff must ensure dressings are applied correctly and changed as instructed.
- Compression therapy: If prescribed, compression bandages or stockings must be applied and monitored for effectiveness and comfort. Staff should regularly check for signs of restricted circulation or discomfort.
- Pain management: If a service user experiences pain during dressing changes, staff must document this and liaise with healthcare professionals for appropriate pain relief options.
All wound care interventions must be documented in the care plan, ensuring a clear record of progress, challenges, and ongoing needs.
3.4 Infection Control and Hygiene Procedures
Infection control is critical in preventing wound deterioration and complications. Staff must follow strict hygiene protocols when providing leg ulcer care, including:
- Hand hygiene: Washing hands thoroughly before and after wound care, using appropriate PPE (gloves and aprons).
- Aseptic technique: Ensuring that wounds are cleaned and dressed using sterile materials to prevent contamination.
- Monitoring for infection: Checking for redness, swelling, heat, pus, foul odour, or increased pain, which may indicate infection. If infection is suspected, staff must immediately escalate the concern to the service user’s nurse or GP.
- Safe disposal of dressings: Used dressings must be disposed of in clinical waste bags, following infection control policies.
3.5 Coordinating with Healthcare Professionals
Leg ulcer care requires collaborative working with external healthcare providers to ensure the best outcomes for service users. {{org_field_name}} ensures that:
- Referrals are made promptly to district nurses or wound care specialists when leg ulcers are identified.
- Care staff communicate effectively with GPs, pharmacists, and tissue viability nurses about treatment plans.
- Service users receive regular medical reviews to monitor healing progress and adjust treatments as needed.
- Emergency escalation procedures are in place for serious complications, such as severe infections, necrosis, or deterioration in wound condition.
Effective communication with healthcare professionals and family members ensures that service users receive holistic, well-coordinated care.
3.6 Staff Training and Competency in Leg Ulcer Care
All care staff providing leg ulcer support must receive training on:
- Recognising the early signs of venous and arterial ulcers.
- Understanding and supporting prescribed treatment plans, including dressings and compression therapy.
- Applying infection prevention measures during wound care.
- Recording and reporting wound observations accurately.
- Supporting service users with pain management, mobility, and circulation improvement.
Training must be refreshed annually to ensure staff remain competent and up to date with best practice guidelines. New employees must receive leg ulcer awareness training as part of their induction.
4. Efficiency in Managing Leg Ulcer Care
To ensure efficient and high-quality care, {{org_field_name}} implements:
- Digital care planning systems, allowing real-time updates on wound care progress and treatment changes.
- Standardised wound assessment tools, ensuring accurate documentation and monitoring.
- Regular quality audits, ensuring compliance with best practice and CIW regulations.
- Close collaboration with district nurses and healthcare teams, ensuring timely intervention.
- Service user education and self-care guidance, promoting active participation in prevention and treatment.
These measures ensure that leg ulcer management is consistent, effective, and person-centred, improving healing outcomes and reducing complications.
5. Related Policies
This policy should be read alongside: Safe Care and Treatment Policy (DCW11), Infection Prevention and Control Policy (DCW17), Risk Management and Assessment Policy (DCW18), Medication Management and Administration Policy (DCW21), Person-Centred Care Policy (DCW07).
6. Policy Review
This policy will be reviewed annually, or sooner if clinical guidelines, CIW regulations, or service needs change.
Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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