Importance of Hosiery Measurement & Selection

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?

Sue Johnson 2002

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

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

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

Stephen-Haynes & Sykes,

Stephen-Haynes & Sykes,

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

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

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

Solutions

• Patient education

• Carer education

• Use of applicators

• Education of the nurses applying hosiery

• Limit choice of hosiery so that education is simpler

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