Diabetic Foot Care Introduction Nurse practitioners prevent foot ulceration, ischemia, deformity, and forming ulcers by implementing appropriate treatment and educating the patient on proper foot care. However, foot related problems in diabetic patients are on the rise and many inpatient units do not have proper education programs to teach these patients how to prevent and manage diabetic foot complications at home. Using evidence-based education and interventions, the inpatient nurse practitioner can prepare patients, caretakers, and family members for discharge home with an increased awareness of their condition and skills to manage their care at home. Objectives Examine the prevalence of diabetic foot complications and the impact on the patients across the nation. Understand the pathogenesis of diabetic foot ulcerations (DFU’s). Describe the Comprehensive Diabetic Foot Exam (CDFE) to identify at risk feet. Examine standards of care regarding diabetic foot care. Investigate preventative strategies to reduce the risk of diabetic foot ulcerations and amputations. Empower Nurse Practitioners and other providers who treat diabetic patients to collaborate to reduce diabetic foot complications and amputations. Diabetes incidence United States: 34.2 Million People, or 10.5% of the U.S. Population Georgia: More than 1 in 10 people (Or more than 1 million people) Augusta, Georgia: Approximately 18% of the population has Diabetes. Georgia Department of Community Health. (2015). Georgia Diabetes Report and Action Plan. Diabetic Foot Statistics Foot ulcers develop in 9.1-26.1 million people every year worldwide. The lifetime incidence of foot ulcers in diabetic patients is 19-34%. More than 50% of DFU’s become infected and 20% with moderate to severe infection result in amputation. Nearly 85% of diabetes-related amputations are caused by an ulcer. In Georgia, the death rate for diabetes is 8% higher than the national average. What does the literature recommend? Article I This report describes the role of the Nurse Practitioner in providing diabetic foot care management in both primary care and specialty care teams. Pathophysiology of diabetic foot ulcers is reviewed, screening tools are recommended, and interventions are described. Barriers to care for patients of nurse practitioners are reviewed. Many foot and ankle complications in diabetic patients are preventable and nurse practitioners should be able to obtain appropriate interventions for their patients since they are managing their disease, providing their education, and helping them to navigate the health care system. Woody, J. (2020). Overview of diabetic foot care for the Nurse Practitioner. The Journal for Nurse Practitioners, (16)1, pp. 28-33. Article II The purpose of this study was to educate patients with diabetes mellitus about the disease and its complications, with emphasis on diabetic foot care. The study first assessed the patient's knowledge of diabetic complications and foot disease using a questionnaire, then it educated the patient’s on diabetic foot care. Finally, the study assessed its intervention by retesting the patients regarding the awareness and knowledge of diabetic foot care. This observational study found that educating patient’s with diabetes will significantly help reduce morbidity and mortality related to diabetic foot complications. Satyam, S., Suhas, J., Samarth, S., and Sourya, A. (2020). Educating patients of diabetes mellitus for diabetic foot care. Journal of Family Medicine and Primary Care, (1), 367. https://doi-org.proxygsu-ecor.galileo.usg.edu/10.4103/jfmpc.jfmpc_861_19 Article III The purpose of this project was to provide interactive self-foot examination education in an outpatient office setting and assess whether rates of daily self-foot examinations were affected. This is an evidence-based quality improvement project. Pre and post intervention surveys were used to assess diabetic foot care knowledge and the frequency of self-foot exams at home. The study found a significant increase in patient’s performing at home foot exams after their education intervention. Branch, J. and Lindholm, L. (2020). Effect of interactive education of diabetic self-foot examinations in Type 2 Diabetes. The Journal for Nurse Practitioners, 16(1), 13-15. https://doi-org.proxygsu-ecor.galileo.usg.edu/10.1016/j.nurp. ra.2019.09.007 Article IV The purpose of this study was to assess the effectiveness of education on diabetic foot ulcer prevention provided to patient’s in rural clinics. This study used pre and post intervention questionnaires to assess patient’s knowledge on foot care. The study found that patient knowledge on diabetic foot care was lacking. There was an increase in the amount of knowledge obtained from the education provided. Green-Morris, G. (2019). An evaluation of the effectiveness of foot care education in rural clinics. Journal of Diabetes & Metabolic Disorders, 18(1), 207.
