Introduction of the Lanarkshire Oximetry Index in community nursing

The aim of this project was to improve access to appropriate, timely and safe application of high compression bandaging for clients with suspected venous leg ulcers (VLUs) with the use of the Lanarkshire Oximetry Index (LOI) when an ankle-brachial pressure index (ABPI) has not be done. An additional aim was to decrease concerns generalist community nurses (GCN) had in relation to the application of high compression bandaging and its effect on blood flow in the lower limbs. This clinical practice improvement project builds on the work done by Field 1 researching why district nurses in the United Kingdom do not apply high compression bandaging. This current project involves community nurses in NSW. The literature review highlighted that there was no research that specifically investigated nurses' concerns and confidence in their ability to apply high compression bandaging without interfering with the client's blood supply. Bianchi et al. 2 published a paper that demonstrated a method of increasing nurses' confidence in their ability to apply high compression bandaging without placing the patients' limb at risk. This method of detecting the arterial status, the LOI, is conducted by the use of a pulse oximeter. Following the implementation of the LOI project, the survey results showed that use of the LOI is achieving a reduction in the time delay for investigations to be performed to ensure safe application of high compression bandaging for clients who have not already had an ABPI. Use of the LOI is results in an increase in nurses' confidence that high compression bandaging has been applied in a safe manner. In summary, the project highlighted the benefits of the LOI method. This method can be used to assess the arterial status of the limb in combination with a complete assessment of the client and the wound before high compression bandaging is applied. Since the conclusion of this project, the LOI has become standard practice in SESIH SHN CH and GCNs have nowpreformed 300 LOIs. Using this tool three clients with critical limb ischemia have been picked up and had urgent surgical intervention. The LOI is now being introduced into the pubic hospital system.