Using compression therapy in a primary care setting to treat complications of chronic venous insufficiency.

BACKGROUND: Patients with chronic venous insufficiency (CVI) are prone to developing complications such as slow-healing venous leg ulcers. LOCAL PROBLEM: Nurse practitioners can assess patients for complications of CVI during routine examinations. If found, they can implement compression therapy and possibly prevent the development of slow-healing venous leg ulcers. METHODS: A retrospective chart review of patient occurrences with complications due to CVI between 2011 and 2018 was conducted to evaluate patient outcomes when treated with compression therapy by their primary care providers (PCPs). Patients were identified by the Unna boot's Current Procedural Technology code, the compression therapy used by the providers. Patients included in the review had the diagnosis of or symptoms of CVI. Patient outcomes were identified as improved, unchanged, or deteriorated. INTERVENTIONS: The use of compression therapy for patients with documented complication of CVI. The Unna boot was the compression device used at this practice. RESULTS: There were 60 occurrences distributed among 40 patients who met the inclusion criteria. Of the 60 occurrences, 54 or 90% of patient occurrences had an improvement of symptoms. According to the Wound Healing Society Guidelines, high compression therapy, such as the Unna boot, is classified as most supportive, for treatment of venous ulcers. CONCLUSIONS: The results of this study demonstrate the positive impact PCPs, including nurse practitioners, may have when initiating compression therapy for patients with complications of CVI.

Feedback-informed treatment and autonomy supportiveness: Effects on children s psychological outcomes.

PURPOSE: Examine the importance of feedback, specifically the perception of parental autonomy support, to reduce youths' premature treatment dropout. DESIGN AND METHODS: A retrospective chart review was conducted, utilizing the convenience-purposive sample of 60 patient charts. Individuals were seen between October 2014 and July 2015 in a community clinic utilizing a treatment approach known as feedback-informed treatment (FIT). FINDINGS: Clients found to have high paternal involvement reported better overall well-being and lower levels of distress. CONCLUSIONS: The construct of parental autonomy support, when combined with a FIT treatment model, is a promising approach to lower the rate of early treatment termination.