Compression therapy is a lifelong intervention, essential for use on patients with venous disorders or ulceration as well as lymphatic disorders or oedema.1 Prescribing compression garments can often be both difficult and overwhelming for clinicians in practice, as many factors need to be taken into consideration.
Prescribing of compression garments
Medical compression prescribed inaccurately, can lead to tissue trauma/pressure damage, particularly if the fabric rolls during wear or is too tight and digs into the skin.2 These experiences result in patients not wanting to comply to treatment options. They lose confidence in the compression treatment and can continue to live with an uncontrolled condition for years. Choosing the correct style and fabric is essential for the comfort and long term concordance for patients.
Factors to consider when prescribing
- Compression classes
- Compression standard
- Fabric stiffness
- Knitting style
- Donning and doffing of garments
- Styles/lengths/foot options
- Supply route/procurement method
- Patient preference
Simplifying the process
A new patient assessment tool was created to help simplify the decision process focussing on:
- Disease progression and clinical symptoms
- Patient body mass index (BMI)
- Limb shape and description.
All three of these areas are easy to assess, and are used in a new, simple scoring tool to help suggest hosiery fabrics for compression based on the individual factors of the patient. In terms of compression class, no recommendation is made as it is believed that the level of compression will be based on a full holistic assessment and resilience of the patient.
Hosiery Hunter & Wrap Hunter in practice
The new tool, named the Hosiery Hunter, was recently developed by Clinical Trainer Megan Hunter from medi UK to simplify and assist in the selection of hosiery fabrics for use in clinical practice. We have also developed a separate Wrap Hunter to be used in conjunction with the Hosiery Hunter:
The tool was introduced into a tissue viability community clinic to evaluate its success on a sample of patients who required compression hosiery following a full holistic assessment. Patient scores were calculated on clinical presentation at initial assessment and suitability of the selected garment was reviewed on follow-up.
Overall, clinicians found that the Hosiery Hunter tool was easy to use, giving them the confidence to select appropriate garments, whilst meeting the individual clinical needs of patients. Suitability of the garments was ultimately judged by the clinicians’ ability to manage the condition, along with patient-led feedback.1
The tool has been successful in:
- Simplifying hosiery selection in a complex arena of compression
- Increasing nurse confidence in relation to compression hosiery decision-making
- Providing patient comfort and support in facilitating self-care and allowing patients to manage their own conditions
- Reducing clinician time and overall cost of care3
1 York K, Freeman N (2019) Simplifying hosiery prescribing with the Hosiery Hunter selection tool. Wounds UK 15(1): 96-103
2 Robertson BF, Thomson CH, Siddiqui H (2014) Side effects of compression stockings: a case report. Br J Gen Pract. 64(623): 316-7
3 Tickle J (2015) Managing venous leg ulcers and oedema using compression therapy. Nurs Stand. 30(8): 57-63