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Health Quality Ontario’s Venous Leg Ulcers Quality Standard focuses on care for people who have developed or are at risk of developing a venous leg ulcer. The scope of the standard covers all settings, including primary care, home and community care, long-term care, and acute care. It also provides guidance on optimal care when a person transitions between these settings—for example, when someone is discharged from a hospital to their home or a long-term care home.

The quality standard includes 13 quality statements addressing areas that have high potential for improving the quality of care in Ontario for people with venous leg ulcers.

Below is a sample of tools that may help you with the implementation of the quality statements into practice, organized according to purpose. Several of these tools will help to support multiple quality statements.

Are there other tools or resources you use? Do you have experience implementing these tools? If you have feedback about any of these tools, please use the comments section below to share!

Individualized Care Plan

The tools and resources identified in the following three sections (Screening for Peripheral Arterial Disease; Patient Education and Self-Management; and Comprehensive Assessment) could also be used to support the development of an individualized care plan.

Screening for Peripheral Arterial Disease*

• ABPI and TBPI Interpretations—a chart shared by the Waterloo Wellington Integrated Wound Care Program to interpret and record the Ankle Brachial Pressure Index (ABPI) and the Toe Brachial Pressure Index (TBPI)
• Measuring and Understanding the Ankle Brachial Index (ABI)—a description from Stanford Medicine for measuring and interpreting the ankle brachial index (ABI)

*Tools from this section can also be used to support the development of an individualized care plan.

Patient Education and Self-Management*

• Caring for Your Leg Ulcer: Compression Therapy—frequently asked questions from Saint Elizabeth Health Care about compression therapy for patients
• My Venous Leg Ulcer—an information pamphlet from the South West Regional Wound Care Program on how to prevent and care venous leg ulcers
• My Venous/Mixed Leg Ulcer Self-Care Wound Dressing Guide—a step-by-step guide by the South West Regional Wound Care Program to help patients and caregivers learn how to change venous/mixed leg ulcer dressings

*Tools from this section can also be used to support the development of an individualized care plan.

Comprehensive Assessment*

• Guideline: The Assessment of People with Leg Ulcer—a guideline by a collaboration of wound care specialists and health agencies in Ontario to help health care professionals assess individuals with a leg ulcer
• Identify and Treat the Cause—a guide by the Waterloo Wellington Integrated Wound Care Program to obtain a comprehensive patient history and perform a physical assessment
• Interdisciplinary Lower Leg Assessment Form—a tool by the South West Regional Wound Care Program to assess pressure injuries in the lower leg

*Tools from this section can also be used to support the development of an individualized care plan.

Compression Therapy

• Compression Stockings for the Prevention of Venous Leg Ulcer Recurrence—a Health Technology Assessment from Health Quality Ontario
• Control of Venous Leg Edema (scroll to #3 and click on “Control of Venous Leg Edema”)—a resource from Wounds Canada to help choose the most appropriate compression therapy

Local Infection Management

• Guideline: Assessment and Treatment of Lower Leg Ulcers (Arterial, Venous & Mixed) in Adults—a guideline developed in part by the BC Provincial Nursing Skin and Wound Committee that provides information for health care providers on assessment and treatments available for venous leg ulcer infections

Treatment with Pentoxifylline

• Identify and Treat the Cause (Pharmacological Treatment)—information from the Waterloo Wellington Integrated Wound Care Program on the use of pentoxyfilline

Referral to Specialist

• Criteria for Interdisciplinary Referrals—a tool by the South West Regional Wound Care Program to help determine if a pressure injury requires an interdisciplinary referral
• Multidisciplinary Team Intervention Referral Criteria Checklist—a tool from the Waterloo Wellington Integrated Wound Care Program that describes criteria for referring patients

Comprehensive Tools and Resources for the Venous Leg Ulcers Quality Standard

The following tools and/or resources may apply to more than one topic in the Venous Leg Ulcer Quality Standard:

• Assessment and Management of Venous Leg Ulcers—a guideline developed by the Registered Nurses’ Association of Ontario
• Regional Wound Care Clinical Practice Guidelines—a comprehensive resource from the Winnipeg Regional Health Authority for venous, arterial, and mixed lower leg ulcers

Comment below to describe your experience with these tools or share any others you have found useful!