A nurse tending to a patient's leg ulcer with ICNP symbols in the background.

Venous Ulcer Care: The Nurse's Guide to Diagnosis & Intervention

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Reese Marlowe in Health & Wellness October 2026 • 3 min read.

"Unlock the secrets to effective venous ulcer management with ICNP-based diagnoses and interventions."


Venous ulcers pose a significant public health challenge, leading to disability, pain, and social isolation, while also straining healthcare resources. Effective management is crucial, yet recurrence rates can be high.

Nursing plays a vital role in wound care, and a systematic approach is essential. Utilizing classification systems for nursing diagnoses, outcomes, and interventions is key to providing high-quality care for individuals with venous ulcers.

The International Classification for Nursing Practice (ICNP) offers a standardized framework, particularly when tailored to specific populations. This article explores the development and validation of an ICNP terminological subset for venous ulcer care, guided by Wanda Aguiar Horta's Theory of Basic Human Needs, which emphasizes the uniqueness of each patient.

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Nursing Care and Service Variation

Nursing care for venous ulcers focuses on wound healing, preventing complications, and supporting overall well-being. The sources emphasize that targeted nursing education can improve assessment and management, and that undertreated or untreated venous reflux increases the risk of complications and ulcers. A review of NHS care reports that venous leg ulcer services can be inconsistent depending on geography and referral, despite published best-practice statements and clinical guidelines.

Assessment and Validated Nursing Framework

A detailed clinical history and thorough assessment of lower-extremity ulcers can aid diagnosis and guide treatment, which may differ by ulcer type. In a study of nursing diagnoses and interventions for people with venous ulcers, experienced nurse judges validated 84 nursing diagnoses and outcomes, along with 306 interventions. These findings document a structured nursing framework, rather than a chronology of historical milestones.

ICNP-Based Nursing Diagnoses and Interventions for Venous Ulcers

A nurse tending to a patient's leg ulcer with ICNP symbols in the background.

A team of experienced nurse judges meticulously validated a comprehensive set of 84 nursing diagnoses and outcomes, along with 306 interventions. This subset, designed to enhance venous ulcer management, incorporates both existing ICNP diagnoses and novel diagnoses identified through research.

The diagnoses were organized using Wanda Aguiar Horta's framework of Basic Human Needs to facilitate clinical reasoning. This organization enables nurses to easily identify and address the holistic needs of patients with venous ulcers.

Here are examples of some nursing diagnoses:
  • Allergy
  • White atrophy
  • Irregular wound edges
  • Cellulitis
  • Full thickness wound
  • Hyperemia
  • Recurrent ulcer
  • Venous ulcer
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Recent Reviews and Recurrence Prevention

A systematic literature review published on November 20, 2023, set out to identify how effective interventions are at promoting self-care adherence to prevent venous ulcer recurrence. A September 1, 2025 literature review examines the epidemiology, pathophysiology, systems costs, and management of chronic venous leg ulcers, arterial ulcers, and diabetic foot wounds in older adults. Two 2025 reviews also emphasize diagnostic variability: leg ulcers can mimic venous leg ulcers, so recognizing differing presentations and considering differential diagnoses are important for accurate diagnosis and care.

Nursing Diagnoses and Ulcer Differentiation

A comprehensive set of 84 nursing diagnoses and outcomes, together with 306 interventions, was validated by experienced nurse judges. The supplied care-plan source identifies impaired physical mobility as a nursing diagnosis for venous stasis ulcer care. Comparative nursing resources frame arterial and venous ulcers by differences in signs, symptoms, complications, and treatment; one chart specifically notes that compression is used for venous ulcers and is dangerous for arterial ulcers.

This study highlights the crucial role of nurses in holistic patient care. By using this subset, nurses can provide well-rounded care that addresses the physical and emotional well-being of those suffering from venous ulcers. This ensures that the best care is delivered.

Putting it all Together

This research confirms that the ICNP is a practical and relevant framework for nurses, promoting well-organized workflows in both outpatient and hospital settings. The use of standardized terminology ensures consistent and effective care.

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Assessment and Nursing Education

Venous leg ulcers are described as the most common cause of leg ulcers, but other causes—especially arterial insufficiency—should be investigated to support appropriate therapy. The cited wound-care review identifies careful clinical examination, standardized documentation, and ultrasound evaluation as important to diagnosis and treatment success. Nursing education projects have evaluated staff knowledge with pretests and posttests; a separate project reports a paired t-test P-value of 0.0431 for primary-care nurse confidence and a statistically significant association between experience and confidence in its pretest analysis.

While this study offers valuable insights, it's essential to remember that clinical judgment remains paramount. Standardized tools like the ICNP subset should support, not replace, the nurse's expertise in tailoring care to each patient's unique needs.

Further studies are expected to assess the subset in diverse clinical environments. Such assessment will provide insight for possible inclusion in the professional practice of nurses caring for people with venous ulcer, in order to be a mechanism for improvement of the care provided.

Healing times and care costs in context

  • 15 daysMedian healing time was 62 days with four-layer bandaging (4LB), compared with 77 days with short-stretch bandaging (SSB), a difference of 15 days.[1]
  • 70 daysMedian time to wound closure was 141 days with intermittent pneumatic compression and 211 days in the control group, a difference of 70 days; the reported comparison had P = .031.[2]

What the reported comparisons suggest

The intermittent-device result indicates faster median closure than the control in that comparison; it does not by itself show that the same result applies across other care settings or treatment approaches.[2]

How treatment conditions shape these findings

In a large compression-therapy trial, many participants received a treatment different from their original allocation during follow-up, which complicates a simple reading of outcomes by assigned group.[3]

For wound measurements using a smartphone application, agreement between assessors was numerically lower for Malay and Indian patients than for Chinese patients, highlighting that measurement performance may differ across groups.[4]

Compression has a boundary condition: strong compression can disrupt arterial blood supply and is not appropriate for people with peripheral arterial disease, so these findings do not describe a universally suitable approach.[5]

What remains uncertain about healing and recurrence

  • Would the relative healing-time pattern between bandaging approaches remain similar if participants consistently received their assigned compression treatment?[1] [3]
  • How do healing outcomes relate to recurrence after closure, given that recurrence is common and guidelines recommend continued compression after healing?[6]

Sources

  1. The Canadian Bandaging Trial: Evidence-informed leg ulcer care and the effectiveness of two compression technologies (pmc.ncbi.nlm.nih.gov)
  2. Faster Healing and a Lower Rate of Recurrence of Venous Ulcers Treated With Intermittent Pneumatic Compression: Results of a Randomized Controlled Trial (pmc.ncbi.nlm.nih.gov)
  3. Compression therapies for venous leg ulcers: The VENous Ulcer Study 6 (VenUS 6), an open, multicentre, randomised clinical trial (pmc.ncbi.nlm.nih.gov)
  4. Clinical validation of a smartphone application for automated wound measurement in patients with venous leg ulcers (pmc.ncbi.nlm.nih.gov)
  5. 2 The diagnostic tests | Automated ankle brachial pressure index measurement devices to detect peripheral arterial disease in people with leg ulcers | Guidance | NICE (www.nice.org.uk)
  6. Compression therapy for preventing venous leg ulcers returning | Cochrane (www.cochrane.org)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

Everything You Need To Know

1

What is the International Classification for Nursing Practice (ICNP) and why is it important in the context of venous ulcer care?

The International Classification for Nursing Practice (ICNP) is a standardized framework that helps nurses provide consistent and effective care for individuals with venous ulcers. It includes a set of validated nursing diagnoses, outcomes, and interventions, ensuring a systematic approach to wound care. Using the ICNP allows nurses to communicate effectively and streamline workflows in various settings, such as outpatient clinics and hospitals.

2

Why are venous ulcers considered a significant health challenge?

Venous ulcers are a significant public health concern due to their potential to cause disability, pain, and social isolation. In addition, managing these ulcers strains healthcare resources. Effective management of venous ulcers is crucial to improve patient outcomes and quality of life. The recurrence rates can be high, making proper care and intervention essential.

3

How do nurses contribute to the care of individuals with venous ulcers, and why is it important?

Nurses play a vital role in the care of patients with venous ulcers. By utilizing the ICNP-based diagnoses and interventions, nurses can provide holistic care that addresses both the physical and emotional well-being of patients. This includes addressing the patient's Basic Human Needs, as defined by Wanda Aguiar Horta's Theory. The ICNP allows nurses to provide consistent care which is essential to deliver the best care possible.

4

How does Wanda Aguiar Horta's Theory of Basic Human Needs relate to the ICNP framework?

Wanda Aguiar Horta's Theory of Basic Human Needs is incorporated into the ICNP framework to guide clinical reasoning. It provides a structured approach to organizing nursing diagnoses, ensuring that nurses consider the unique needs of each patient with venous ulcers. By using this framework, nurses can address the holistic needs of patients, leading to improved care and outcomes. The ICNP allows nurses to easily identify and address the holistic needs of patients.

5

What specific diagnoses and interventions are included in the ICNP subset for venous ulcer management?

The research identified and validated a comprehensive set of nursing diagnoses, outcomes, and interventions using the ICNP. The study included 84 nursing diagnoses and outcomes along with 306 interventions. The use of this subset is designed to enhance venous ulcer management. Some examples of diagnoses include 'Allergy', 'White atrophy', and 'Recurrent ulcer'. This validated subset ensures that nurses have the tools and resources needed to provide high-quality care, improve patient outcomes, and promote well-organized workflows.

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