Benefits of Educating Nurses to Perform Foot Assessment on People with Type 2 Diabetes - Assignment Example

What are the Benefits of Educating Nurses to Perform Foot Assessment on People with Type 2 Diabetes to Identify High Risk Diabetic Foot? Chapter One 1.0 Introduction Diabetes prevalence has risen dramatically and similarly the complications associated with diabetes. As of 2013, it was reported that 347 million individuals had diabetes globally making diabetes a global epidemic (Khunke et al, 2014). Diabetic foot disease is among the most common diabetes complications. Studies show that even though diabetic foot disease and its complications are preventable, it has become a serious worldwide burden (Khunke et al, 2014). Appropriate foot care can reduce amputations that result from foot diabetic disease. As Crozier (2014) explains, amputations in many diabetic foot problems can be avoided through early detection and suitable referrals. Basically, nurses are the healthcare professionals who are actively involved when it comes to preventing and early detection of diabetes complications such as diabetic foot disease (Aalaa et al, 2012). Nurses are well placed to perform appropriate foot assessment that include early detection of any skin and sensation changes, assessing footwear, assessing education need and self-care capacity (Aalaa et al, 2012). Proper education and training on foot care assessment also enables nurses to provide the effective services to promote the health of patients with diabetic foot disease (Aalaa et al, 2012). Many healthcare institutions and diabetes clinics have nurses who do not have the required training as podiatrists. As studies show, diabetic foot problem is a highly prevalent in patients with diabetes and therefore this study aims at examining the significance of nurses performing appropriate foot assessment The main goal of foot assessment is to identify characteristics such as sensory and vascular impairments that place an individual at risk of foot problems and amputation (Redman et al, 2014). Foot assessments are done to identify high risk foot through indicators such as history of ulcer, peripheral neuropathy, foot deformity as well as peripheral vascular disease. Another reason for performing foot assessments is to identify active foot problems by examining for infection, ulceration, skin breaks, nail disorders or calluses or corns (Etnyre et al, 2011). Nurses need to have the required knowledge and skills to competently carry out foot assessments in patients with diabetes (Blatchford et al, 2015).  Educating nurses not only equips them with important knowledge of identifying patients who are at risk of foot ulcers and but also enables them to be competent in performing diabetic foot assessments which in turn reduces complications such as limb amputations (Etnyre et al, 2011). The study has undertaken a literature research methodology by searching peer-reviewed journal articles through academic databases namely; Google Scholar, OVID and CINAHIL to evaluate the benefits of educating nurses to perform foot assessment on people with type 2 diabetes to identify high risk diabetic foot. 1.1 Study Background In people with Type 2 diabetes, the onset of sensory neuropathy signifies the risk of foot ulceration which is the basis of diabetic foot disease (Aalaa et al, 2012). Research has established that foot ulcer precedes most of lower extremity amputations in people with type 2 diabetes (Tang et al, 2014). Diabetic foot disease is the ulceration of the foot allied to neuropathy as well as various grades of ischemia and infection. Diabetic foot disease is the most common cause of hospitalization of people with diabetes and the most-demanding diabetes complication when it comes to financial aspect and nursing care as well. In addition, diabetic foot disease is also considered a major cause of mortality in patients with diabetes and it also leads to infection, gangrene, and amputation if the appropriate care is not provided. In individuals with diabetes, the prevalence of foot ulceration is 4% to 10% and the lifetime incidence can be as high as 25 percent (Tang et al, 2014). Even though many different healthcare providers play a role in reducing incidence of diabetic foot disease and amputation, the role of nurses is extremely essential. Adequately skilled nurses in diabetic foot assessment are able to detect diabetic foot changes early and in turn implement the required interventions to prevent further complications which can lead to limb amputation (Crozier, 2014). Therefore, educating nurses on proper foot assessment can assist in reducing the number of limb amputations and enable individuals with diabetes to sustain their quality of life and their independence as well (Aalaa et al, 2012). Nurses need knowledge and understanding as well as clinical expertise to be able to perform effective assessment of diabetic foot disease. Timely and prompt treatment of diabetic foot ulcers can prevent the problem from exacerbating and hence eliminate the probability of amputation (Jenkins et al, 2011). Nonetheless, studies show that some nurses are not competent in foot assessment and this is due to lack of education which is a hindrence to effective foot assessment and appropriate treatment in people with diabetes (Blatchford et al, 2015). 1.2 Assessment of ‘Diabetic Foot Disease’ Proper assessment of the feet includes a comprehensive neuropathic, musculoskeletal, structural as well as vascular assessment. Neuropathic assessment consists of history to encompass neuropathic symptoms, examining pressure sensation through monofilament and examining vibration sensation (Redmon et al, 2014). Structural assessment entails identification of the structural abnormalities like flat foot, bunions, claw toes, calluses and hammer toes and also identification of Charcot neuroarthropathy. Vascular assessment includes history to encompass; claudication symptoms, identification of cutaneous trophic changes like skin, foot color, temperature, calluses, ulcers or frank digital gangrene, palpating pedal pulses, Arterial Doppler some cases (Crozier, 2014). During diabetic foot assessment, nurses examine the feet of patients in order to screen patients who are at high risk of diabetic foot disease and associated complications and make the required reports and referrals to the appropriate healthcare professionals (Aalaa et al, 2012). During diabetic foot assessment, nurses might perform vascular assessment using an ankle brachial index and also toe pressure. In addition, pedography system and thermometer can be utilized to examine foot sole pressure along with foot temperature as this will enable identification of foot problems, their severity and those at risk of diabetic ulcers (Etnyre et al, 2011). Therefore, nurses also require skills on how to operate the required devices and equipment to perform diabetic foot assessment. 1.3 Problem statement Studies show that the outcome of diabetic foot disease is poor and the increasing rate of amputations due to diabetic foot disease remains high in spite of the available preventative methods such as foot assessment to detect foot ulceration. Evidence shows that about 50 percent of amputations that occur annually in people with individuals can be prevented through proper foot assessment and provision of appropriate foot care (Tang et al, 2014). Complications of diabetic foot disease are devastating and commonly result in amputation if there is no early intervention. As aforementioned, most of amputations from diabetic foot disease are preceded by a foot ulcer and hence proper foot care assessment can play a big role in preventing the amputations. One contributing factor to poor outcome in diabetic foot disease is lack of the required skills and expertise to perform foot assessment (Metta et al, 2015). Therefore, there is need to carry out this study to establish if educating nurses on how to perform foot assessment on people with type 2 diabetes to identify high risk diabetic foot helps in reducing rates of amputation and having good outcome of diabetic foot disease. 1.4 Study Significance This study will be important to all healthcare stakeholders because this study will inform benefits that come with educating nurses on how to perform foot care assessment. As the primary care provider, nurses are the best suited for initiating preventive action early in order to slow the progress of diabetic foot disease and reduce amputations and other complications. In addition, the proposed study is anticipated to contribute to the existing knowledge and literature in regard to the importance of educating nurses on how to perform foot care assessment. Moreover, this study will be a basis for further research. Reference List Aalaa M, Malazy T, Sanjari M, Peimani M & Mohajeri M, 2012, Nurses’ role in diabetic foot prevention and care; a review, J Diabetes Metab Disord, 11( 24). Blatchford L, Morey P & McConigley R, 2015, Identifying type 2 diabetes risk classification systems and recommendations for review of podatric care in an Australian Aboriginal health clinic, Journal of Foot and Ankle Research, 8(34). Crozier, L, 2014, Diabetic Foot-related Problems: Improving outcomes in the Dialysis Population using Foot Assessment Screening Tri-algorithm (FAST), Nephrology Nursing Journal, 41(4). Etnyre A, Perla Z, Roehrick L & Farmer S, 2011, The role of certified foot and nail care nurse in the prevention of lower extremity amputation, J Wound Ostomy Continence Nurs, 38(3): 242-251. Kuhnke J, Bailey P, Woodbury G & Burrows M, 2014, The role of qualitative research in understanding diabetic foot ulcers and amputation, Advances in Skin & Wound Care, 27(4). Jenkins C, Myers P, Heidari K & Kelechi T, 2011, Efforts to Decrease Diabetes-Related Amputations in African Americans by the Racial and Ethnic Approaches to Community Health Charleston and Georgetown Diabetes Coalition, Fam Community Health Supplement 1, 34, No. 1S, pp. S63–S78. Metta E, Bailey A, Kessy F, Geubbels E, Hutter I & Haisma H, 2015, In a situation of rescuing life: Meaning given to diabetes symptoms and care-seeking practice among adults in Southeastern Tanzania: A qualitative inquiry, BMC Public Health, 15(224). Turns M, 2015, Prevention and management of diabetic foot ulcers, Br J Community Nurs, Mar;Suppl Wound Care:S30, S32, S34-7. Redmon B, Caccamo D, Flavin P, Michels R, O’Connor P, Roberts J, Smith S, Sperl-Hillen J, 2014, Diagnosis and Management of type 2 diabetes mellitus in adults, Institute for Clinical Systems Improvement. Read More