Importance of Hosiery Measurement & Selection

1. Importance of Hosiery Measurement & Selection

5. Practical Hosiery • The use of compression hosiery is widespread, but there is wide variation in almost every aspect of selection and prescribing practice • Also, there are hundreds of types • There are different classes – different testing standards (RAL; British Standards) • How can the nurse make good judgement about the type required by the individual patient with such an enormous choice?

6. Sue Johnson 2002

7. Testing Standards • UK Class 1 - 14-17 • UK Class 2 - 18-24 • UK Class 3 - 25-35 • RAL Class 1 - 18-21 • RAL Class 2 - 23-32 • RAL Class 3 - 34-46 • RAL Class 4 - 49

8. Practical Hosiery • In some areas pharmacists or appliance officers are responsible for selecting a suitable stocking for patients (education? ABPI?) • Other areas it may be left to medical staff (education? ABPI?) • Pharmacists report being given a prescription that states ‘hosiery’ • Anecdotally, there is a lack of knowledge about when and what is safe to prescribe relative to the underlying disorder

9. Practical Hosiery • The discrepancy between testing standards can cause confusion • All of this could lead to the patient being prescribed the wrong type for the individual need

10. Stephen-Haynes & Sykes,

11. Stephen-Haynes & Sykes,

12. My Experience of Hosiery • In the Wound Healing Centre and throughout Eastbourne, CCG we have a selection of two makes of hosiery and two types (1 RAL and 1 British Standard) • This enables us to educate all nurses in the area in measurements and correct class and test standard selection for individual patients • It makes life simple for us all

14. My Experience of Hosiery • We have great success in treating with hosiery • This is due to accurate measuring; application; education of the patient and commitment of the clinicians • We do not win them all, but we do win the majority

15. Ramifications of Assessment • One of the problems associated with supplying compression hosiery is concordance from the patient • If they have difficulty applying the hosiery then it will not be used • This ensures that the patient will, at some point, return with another wound • This needs to be addressed during assessment

16. Solutions • Patient education • Carer education • Use of applicators • Education of the nurses applying hosiery • Limit choice of hosiery so that education is simpler

17. Conclusion • Use of compression hosiery for venous disease is underrated • It is cost effective for prevention and treatment • Education is vital to enable appropriate selection of product • Measurement is simple and important to the safety and healing of the patient