Assessing the Impact of a Training Intervention on Venous Compression Bandaging Application: A Factorial Design Randomised Trial.

Abstract

Venous leg ulcers (VLU) are a major complication of chronic venous disease, with compression therapy as the gold-standard treatment. This 2 × 2 factorial randomised open-label trial assessed the effect and three-month sustainability of a one-hour training intervention on compression bandaging quality among 50 advanced practice nursing students (APNS) in France, using two different compression bandage types (system A or system B) on a mannequin leg. The primary outcome was the Control Score of compression bandaging (CCB score, 0-7). Secondary outcomes included installation conformity, application time, and satisfaction. At baseline, mean CCB score was 3.78, with 52% installation conformity. The intervention did not significantly improve the CCB score compared to controls (adjusted difference: -0.43; 95% CI: -1.01 to 0.15). A significant interaction between bandage type and intervention was found for installation conformity: a tendency to improve with system B and decrease with system A. Improvements observed at 1 month were not sustained at 3 months. Application time decreased over follow-up, and system B was applied more efficiently than system A. Brief, behaviourist-based training was insufficient to achieve lasting skill improvement. Findings highlight the need for repeated group practice, feedback, and integration into relevant clinical contexts to enhance compression bandaging proficiency.