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Tissue Viability ServicesIntroductionThe Tissue Viability Team provides specialist and expert services to patients with pressure sores, leg ulcers, trauma injuries, superficial burns, abdominal wounds, etc. These services are provided directly to patients through daily clinics at Lever Chambers Centre for Health (often referred to as the Leg Ulcer Clinic), together with domiciliary and hospital visits to see patients with particularly complex needs. As an equally high priority, the team provides specialist and expert advice to other healthcare professionals across the Bolton health and social care community regarding tissue viability related issues, this includes advice on the provision of pressure relieving equipment, notably beds both to the PCT and the hospital. The team also participate in a range of research trials linked to the service area. Patient careA paper referral from any healthcare professional is processed by the clerical officer. If the referral is accepted the clerical officer will telephone the patient and arrange a suitable appointment in the clinic. Following this initial assessment appointment, a follow up appointment is made with the patient as they leave the clinic. This continues until the patient is able to be discharged (if their condition has healed), or transferred (if the condition has stabilised and a patient can therefore be cared for more locally to their home). When a patient's condition becomes more stable, the patient is often transferred to a district nurse led leg ulcer clinic at a local health centre, with a management plan set by the central clinic. On average approximately 40% of patients are transferred to district nurse clinics, 25% of patients remain at the central clinic for over 6 months and 35% of patients are discharged directly from the central clinic within 6 months. The district nurse clinics run across Bolton in treatment rooms including Avondale Health Centre, Egerton & Dunscar Health Centre, Horwich Clinic, Westhoughton Clinic, Pikes Lane, Farnworth and Tonge Fold Health Centre. On occasion the district nurse clinics may refer patients back to the central clinic for a further assessment or advice, should the patient develop more complex needs. On average patients require one/two visits to the central clinic, however there are a number of patients who have persisting complex ulcers and who have been with the clinic, attending once or even twice a week, for several years. Specialist/expert care and adviceReferrals are received for specialist/expert care and advice following a face to face patient visit by a range of healthcare professionals, where they are not able to care for the patient alone. Whilst sufficient telephone advice can sometimes be provided, over 75% of referrals require a face to face visit by a member of the Tissue Viability Team. These are largely provided by the nurse consultant or specialist nurse. Currently 70% of referrals are for inpatients at Royal Bolton Hospital. Advice, management plan recommendations and/or treatment are provided during the visit. Follow up visits are required for approximately 25% of patients who have particularly complex needs. ResearchThe current research trial with York University involves patients with venous leg ulceration. They are randomly allocated to three different treatment regimes (Loose Larve, Bio-Bagged Larve and a Hydrogel). The progression of the wound is measured by tracing, photographing and swabbing weekly. An additional research project led by Dr Onwudike regarding exercise linked to leg ulcers has recently commenced. This requires clinic staff to educate those patients allocated to the exercise treatment plan regarding particular exercises. All research has strict criteria and involvement is limited to specific patient groups. Patients invited to be involved in the research will be fully informed of what this will involve and is then asked to decide whether they do or do not wish to be involved in the research. The Team
Contact Details:Tissue Viability Team
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