Capstone Project Change Proposal: Prevention of Diabetic Foot-Ulcers
Introduction
Diabetes mellitus is a chronic metabolic disease resulting from high blood sugars.
Over 30 million Americans have diabetes and approximately 15% of them have Diabetes foot ulcer (CDC, 2019).
The trend of Diabetics is rising, and simultaneously, diabetic foot-ulcer.
This diabetic’s pathophysiology is preventable if patients manage diabetes.
Therefore, it is vital to develop a long-term intervention plan to assist patients in managing diabetes.
Speaker notes
- Diabetes mellitus is a chronic metabolic disease characterized by a microvascular and macrovascular complication that develops as a result of high blood sugar levels.
- Over 30 million Americans have diabetes and approximately 15% of them have Diabetes foot ulcer
- A diabetic foot ulcer is an open wound that occurs on the bottom of the foot
- The condition can sometimes result in amputation
PICOT Statement
P – Inpatient adult patients with type 2 diabetes
I – Intensive Therapy and intensive nursing education
C – To reduce the risk of diabetic foot ulcers compared to patients who do not undergo intensive therapy
O – Reduce the risk of diabetic foot ulcers by 5%
T – Six months to achieve the reduction of 5%
Speaker notes
The change proposal entails a study for the prevention of diabetic fool ulcers through the use of intensive therapy.
Intervention
The intervention is intensive therapy with intensive nursing education.
Intensive therapy will utilize insulin as it is reported as the most effective glucose-lowering agent (Nathan et al., 2009).
In the intervention, patient involvement and education will be one of the priorities.
The second intervention is getting the nurses to be knowledgeable.
It is vital as it makes nurses well-versed with novel medical protocols and be in a better position to evaluate risks and the therapy.
Speaker notes
Patient involvement in the implementation plan includes patient education and patient recommendations on various strategies used. Intensive therapy for diabetic management requires proper education of patients on the issues surrounding their condition and the management of the condition.
Evidence-Based Literature
Diabetic foot ulcers mostly have an extended healing time (Cummings et al. 2014).
Routine foot checks are recommended.
The direct association between diabetes type 2 and foot ulcers shows the importance of developing a long-term solution
The successful management of diabetes requires patient’s inputs (Chaudhury et al. 2017).
Intensive therapy has shown to improve patients’ outcomes and reduce the overall cost of care (Hillard et al., 2016)
Speaker notes
Objectives
General Objective
To develop an intervention that could help to prevent diabetic foot ulcers in diabetes type 2 patients.
Specific Objectives
To carry out insulin therapy on patients suffering from diabetes type II
To intensively educate nurses
To evaluate how the two specific objectives, reduce the risk of diabetes foot ulcers.
Speaker notes
Resources Needed
Adults suffering from diabetes in inpatients settings.
Nurses who will willingly and comfortably partake in the educational seminars and eventually take care of the study patients.
A huge quantity of insulin.
Educational materials for the nurses and patients such as the curriculum, handouts, and brochures.
Equipment for collecting patient and nurses’ feedback
Speaker notes
Anticipated Measurable Outcomes
Patient and nurses’ feedback
To understand the procedures that are more likely to improve the patient outcome.
The therapy’s risks and efficiencies
Risks include the side effects of insulin, while efficiencies are the change in diabetes severity.
Patients’ frequency of inspecting their feet.
Speaker notes
Insulin therapy can result in side effects such as hypoglycemia, anxiety, dizziness, rashes.
Patients need to inspect their foot daily for cuts, blisters, swelling, redness, or nail problems. Non-compliance with this procedure might result in the unnoticeable development of foot ulcers.
Evaluation of Intervention
Conducting an evaluation of the intervention closely pays attention to the objectives of PICOT.
The main objective in the research is the reduction of incidences of diabetic foot ulcers within half an year.
An evaluation will be done between patients receiving intensive therapy with those not receiving the treatment plan.
Speaker notes
References
Centers for Disease Control and Prevention (2019) Type 2 Diabetes Retrived from https://www.cdc.gov/diabetes/basics/type2.html
Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et al.(2009) Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009;32:193–203., Holman RR, Sherwin R, Zinman B, American Diabetes Association., European Association for Study of Diabetes. Diabetes Care. 2009 Jan; 32(1):193-203.
Chaudhury, A., Duvoor, C., Dendi, R., Sena, V., Kraleti, S., Chada, A., … & Kuriakose, K. (2017). Clinical review of antidiabetic drugs: implications for type 2 diabetes mellitus management. Frontiers in endocrinology, 8, 6.
Cummings, A., Rice, J., Desai, U., Birnbaum, H., Skornicki, M., & Parsons, N. (2014). Burden of Diabetic Foot Ulcers for Medicare and Private Insurers. Diabetes Care 2014; 37:651–658. Diabetes Care, 37(9), 2660-2660. https://doi.org/10.2337/dc14-er09
Hilliard, M. E., Powell, P. W., & Anderson, B. J. (2016). Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. American Psychologist, 71(7), 590.