Page 176 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Compression Bandaging 151

patient including tissue damage, pain, oedema and necrosis
(Todd 2011 ), which could (obviously) significantly impact
patients’ overall wellbeing (Milne 2013 ).
It has also been identified that national guidelines (e.g.
RCN 2006 ; SIGN 1998 ; CREST 1998 ) for compression ban-
daging are not always followed (Sadler et al. 2006 ; Templeton
and Telford 2010 ). Randell et al. ( 2009 ) identified that nurses’
decision on which compression dressing to apply usually
relied upon past clinical experience with some nurses more
.

than willing to give a particular dressing ‘a go’ Additionally,
nurses who were interviewed felt as if guidelines for compres-
sion bandaging were of limited use to them and their patients
and they worked outside of these guidelines for these rea-
sons. It was also noted by Randell et al. ( 2009 ) that these
guidelines were often prepared by GP’s without consultation
with the expert nurses who took primary responsibility for
caring for those with wounds. This subsequently led to many
guidelines never being properly consulted by nurses, and
‘bending them’ to suit the health care professionals needs.
Research has also suggested reasons for reluctance on
the part of nurses to use compression bandages: fear of com-
pression damage; the patient having mobility or footwear
issues; problems with patient concordance; and uncertainty
over treating mixed aetiology ulcers (Field 2004 ; Annells
et al. 2008 ; Randell et al. 2009 ; Todd 2013 ; Ashby et al. 2014 ).
Furthermore, it is essential that nurses who apply these types
of bandages understand the theory behind it and the differ-
ences in sub-bandage pressure, failure to do so may lead to
longer healing times, pressure damage and even amputation
(Todd 2011 ).
In sum, nurses’ understanding of compression bandages,
including using the correct compression recommended, the
type of compression bandage used, the bandaging technique
used, and, indeed, even if nurses decide to use compression
bandages, can all impact on their correct use, patient con-
cordance and the patient experience (Feben 2003 ; Puffett
et al. 2006 Annells et al. 2008 Randell et al. 2009 ; Todd 2013 ;
;
;
Ashby et al. 2014 ).