{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:53:56Z","timestamp":1781668436451,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,12]],"date-time":"2025-01-12T00:00:00Z","timestamp":1736640000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013842","name":"Imperial Health Charity","doi-asserted-by":"publisher","award":["RFPrD1920\/109"],"award-info":[{"award-number":["RFPrD1920\/109"]}],"id":[{"id":"10.13039\/100013842","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Guidance for venous leg ulceration (VLU) recommends compression therapy and early referral for specialist vascular assessment within two\u2009weeks. Few patients receive timely assessment and referral. Reasons for this are unclear. The aim of this work was to explore nurses' perceptions of the barriers and facilitators to early assessment of VLU and referral for specialist treatment. One\u2010to\u2010one semi\u2010structured interviews explored experiences caring for and referring patients with VLU to a vascular specialist. Maximum variation sampling and inductive thematic analysis were used. Eighteen nurses participated. Findings suggest junior nurses lack knowledge and confidence to care for VLU and often revert to a \u2018task\u2010based\u2019 approach, exacerbated by staff shortages and limited training. Because VLU occurs in the context of competing conditions and pressures, comprehensive assessments are missed, and the need for referral is not established or prioritised. Supporting patients to self\u2010manage is seen as a possible solution. Nurses reported disjointed pathways between primary and secondary care, compounded by poor MDT collaboration, ineffective communication systems and inadequate data sharing. Consequently, when the need for referral is established, communicating this between healthcare organisations is complex. Organisational and behavioural barriers impact nurses' ability to promote timely referral. Further exploration with patients and other healthcare professionals is needed.<\/jats:p>","DOI":"10.1111\/iwj.70071","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:41:41Z","timestamp":1736728901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A qualitative exploration of the barriers and facilitators to early lower limb assessment and onward referral for specialist treatment for patients with venous ulceration"],"prefix":"10.1111","volume":"22","author":[{"given":"Layla","family":"Bolton Saghdaoui","sequence":"first","affiliation":[{"name":"Section of Vascular Surgery\u2014Department of Surgery and Cancer Imperial College London\/Imperial College Healthcare NHS Trust Charing Cross Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smaragda","family":"Lampridou","sequence":"additional","affiliation":[{"name":"Section of Vascular 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