Community leg ulcer visit to a frail older man at home
NMC OSCE practice station

The task

You are a community nurse making a home visit. Harold Pickering, aged 84, lives alone and has had a leg ulcer on his right leg for five months. His daughter, Joanne, is visiting. His GP can be reached by phone. Introduce yourself, assess Mr Pickering, his leg and the ulcer, and consider his general health and safety at home. Decide what care he needs and whether anyone must be told today. Record your findings and plan on the form provided. Say aloud what you are checking and why, and explain your plan to Mr Pickering and his daughter.

What this station tests

• Not every leg ulcer is venous; night pain, cold feet and absent pulses suggest arterial disease.
• Assess arterial supply before applying compression bandaging.
• Use aseptic non-touch technique and a non-adherent dressing while the plan is agreed.
• Assess the whole person: nutrition, falls, mood, home safety and support.
• Escalate to the GP the same day with SBAR when you see signs of ischaemia.

Sources for the clinical content

• NICE CKS: Leg ulcer, venous
• SIGN 120: Management of chronic venous leg ulcers
• NICE CG147: Peripheral arterial disease
• NMC: The Code

An original practice scenario with invented patients. Not an exam question.

Practise next

• Breathless older patient with a chest infection
• Worsening abdominal pain after bowel surgery
• Confused patient after a fall with a head injury
• Children's nursing assessment of a child with a high fever
• Midwifery postnatal home visit with a feeding problem