Enhancing Diabetic Foot Care: Nurse Training for Better Outcomes

Introduction

Diabetes is a chronic, complicated illness that can lead to amputation of the lower limbs, and other serious consequences include heart disease, stroke, blindness, kidney failure, neuropathy, and diabetic foot ulcers. Diabetes patients’ quality of life is substantially impacted by diabetic foot. Due to the extreme morbidity and mortality, there is a loss of the workforce, emotional damage, and expensive medical expenditures (Pourkazemi et al., 2020). Amputations are carried out every 30 seconds owing to diabetic foot problems worldwide, with 25% of persons with diabetes eventually developing diabetic foot ulcers (Ross, Lechleitner, and Oberaigner, 2021). One of the most frequent causes of hospitalization for diabetes is diabetic foot. There is currently a need for adjustment of the educational programs for staff to meet the needs of the patients by UK standards, which will enhance health outcomes.

Area for Improvement

In such a way, diabetic foot is one of the issues that should be given much attention. Disregarding the symptoms and signs of the disease might result in severe complications, including amputation (Pourkazemi et al., 2020). For this reason, timely detection and appropriate care are crucial for promoting positive outcomes among patients. However, the problem is that there is a deficit in knowledge among the medical staff related to how to detect diabetic foot and manage it (Kaya and Karaca, 2018). Currently, nurses are not trained on how to assess the condition and ensure its effective and correct management. As stated previously, 25% of clients might acquire foot ulcers, making the issue extremely topical (Ross, Lechleitner, and Oberlander, 2021). At the same time, the lack of training among nurses and health workers regarding the existing national standards complicates the cooperation with the patients and worsens outcomes. It means there is an urgent need to improve the situation and ensure the staff is trained to detect, diagnose, and treat diabetic feet.

Eliminating the lack of knowledge is central to attaining enhanced outcomes. Nurses are critical members of the diabetes treatment team (Kaya and Karaca, 2018). However, the relevant statistics show that 66% of nurses did not receive training in foot care, and 80% did not educate patients about their foot problems (Kaya and Karaca, 2018). Moreover, 77.5% of nurses do not perform foot examinations regularly, which impacts outcomes and the emergence and development of complications, including amputation (Kaya and Karaca, 2018). Furthermore, in many cases, nurses who possess adequate knowledge of diabetic foot management do not use it in practice because of the lack of training (Kaya and Karaca, 2018). It results in the emergence of numerous problems and undesired outcomes.

In such a way, the outlined area for improvement is relevant and requires much attention. The introduction of practical training programs would help to alter the situation and attain significant improvement in outcomes and client satisfaction. The timely detection of the first symptoms will reduce the number of adverse effects, complications, and amputations. For this reason, nurses, as essential members of diabetes care teams, should be provided with education and training. It might also reduce the cost of treatment, meaning that the intervention can be cost-effective and improve the whole sector’s work.

Possible Change and Training

Training given to nurses about diabetes foot and its management is currently inconsistent. For health workers, patients with a high risk of developing diabetic foot problems should be of particular concern. However, nurses might need more information about the consequences of the condition and how to prevent them. For diabetes patients without established (overt symptoms) neuropathy or peripheral vascular disease, there are not many precise, evidence-based guidelines for the content or delivery of foot care recommendations (Hartmann-Boyce et al., 2020). Studies have shown that healthcare professionals lack experience in treating a diabetic foot, and in many cases, foot surgery is performed (Schmidt et al., 2020). It is a serious concern that cannot be disregarded as it impacts the quality of care.

For this reason, it is essential to cultivate awareness about the possibility of developing diabetes-related changes, such as foot numbness with the risk of ulceration due to peripheral neuropathy (Schmidt et al., 2020). Nurses should be explained that the therapy of a patient with established foot lesions should include exams following the existing guidelines on diabetic foot management (Schmidt et al., 2020). Furthermore, considering the lack of knowledge mentioned above, healthcare providers must deepen their awareness of how the theoretical knowledge they possess might be used in real-life settings to avoid complications and surgeries (Schmidt et al., 2020). It means that the focus on practice and assessing clients’ current needs should be cultivated.

Furthermore, the organizational change in diabetic foot care is essential for training nurses. The work of healthcare facilities should be altered regarding the alarming prevalence of diabetes in the community. Data demonstrate that diabetic foot is a significant consequence of diabetes that requires immediate attention (Pourkazemi et al., 2020). Amputations of the lower limbs are done on 40–60% of diabetic patients, and more than 85% of these amputations are due to gangrenous and deeply infected diabetic feet (Dewi and Hinchliffe, 2020). To lower the frequency of diabetic foot amputations, which account for nearly half of all amputations, diabetic feet must be treated appropriately. For this reason, healthcare providers and members of diabetic management teams should be equipped with guidelines on evaluating the condition and resources necessary for its effective treatment.

Thus, the educational program’s primary objective is to lower the number of complications linked to the diabetic foot and its poor management. A thorough teaching program and organizational change may successfully lower the number of problematic cases and undesired conditions (Astasio-Picado, Cobos-Moreno, and Gómez-Martín, 2021; Chan et al., 2020). The development of vascular problems in the foot, which can result in lower limb amputations, is markedly slowed by maintaining blood glucose levels as near to normal as feasible (Dewi and Hinchliffe, 2020). To achieve this aim, it is essential to develop an educational program that would raise knowledge about the problem and its management among nurses. The treatment of diabetic foot, aligned with the recent care recommendations, increases survival, decreases diabetic foot complications, and is even more affordable (Chan et al., 2020). As a result, a thorough education offers a toolkit and resources to assess, diagnose, and manage diabetic foot, raising the medical care standard.

To meet the current patient’s needs, nurses must know the underlying reasons and risk factors for ulceration and amputation. Up to 85% of amputations can be avoided with early discovery, screening, and effective treatment of these ulcers (Firdaus and Jittanoon, 2021). It is important to carefully plan the course of therapy and devote attention to the first symptoms of diabetic foot. Nurses should be trained to maintain cardiovascular function, avoid ischemia, and enhance blood flow to the lower limbs (Pourkazemi et al., 2020). Furthermore, the investigation shows that using the clinical pathway and associated resources, such as toolkits or guidelines, nurses might significantly enhance the quality of care provided to patients with diabetic foot and attain enhanced outcomes (Chan et al., 2020). For this reason, in-person training and education provided to nurses is the key to boosting their performance and equipping them with knowledge essential for improving diabetic foot management. Nurses might also work as part of High-Risk Foot Teams (HRFT) to acquire the knowledge necessary for better managing the condition (Chan et al., 2020). It would help to acquire new experiences and practical skills necessary for working in diverse conditions and healthcare facilities.

Altogether, the information above proves that education is essential for addressing the problem of diabetic foot. Diabetes is a multifaceted disease that must be appropriately treated with particular knowledge and abilities. Employees can be equipped with the knowledge and abilities to give patients with diabetes high-quality care based on educational programs (Dewi and Hinchliffe, 2020). Nurses familiar with diabetes foot peculiarities can help patients and increase their satisfaction. Health workers who have received training can recognize and treat possible diabetes foot-related problems and reduce complication rates.

Furthermore, nurses who have received education on diabetes foot are more certain in their capacity to handle responsibilities related to the condition. This may increase job satisfaction and higher productivity (Chan et al., 2020). Staff members can create individualized treatment regimens that are catered to the particular needs of each patient with the aid of diabetes education. By doing this, one can guarantee that patients get the finest treatment possible. Employees may keep up to date on the most recent industry standards and best practices for diabetes treatment with the aid of diabetes education programs. By doing this, the healthcare facility can make sure that it complies with regulations and follows best practices.

Educational Priorities

There are four main educational priorities for the programs of staff education. These priorities are concentrated on patient care and should provide the framework for workers to prepare themselves and educate patients on the need for certain treatment options. They frequently get their feet evaluated, go to yearly foot exams, have adequate glycemic control, and report any changes in foot health to their doctor right away.

All diabetes patients should be confident enough to demand that an appropriately qualified healthcare practitioner do an annual foot examination on them. Patients should be informed about the assessment procedure; for instance, sensitivity testing is done to determine the current state of the nerve damage (Ross, Lechleitner, and Oberlander, 2021). They need to know what kind of treatment to anticipate and that the health worker is taking appropriate care of their feet. Lower HbA1c levels have been linked in several clinical trials to a lower risk of microvascular complications of diabetes, such as neuropathy and foot ulcers (Dewi and Hinchliffe, 2020). Patients need to understand this relationship. Therefore, it is important to dispel myths about it, such as the idea that diabetes will always result in amputation and that ulceration and neuropathy are related. It should be emphasized that a patient who takes proper care of their diabetes, i.e., controls the amount of glucose in their blood, can avoid numerous foot issues. It is essential to give the patient adequate time to ask inquiries.

Many nurses and patients might not know the importance of daily foot checks. However, it is a central aspect of managing diabetic food and avoiding severe complications. The studies contend that crucial indications to check during the foot assessment include discoloration or skin cracks, swelling, discomfort, or numbness (Schmidt et al., 2020). Nurses should realize that addressing these aspects is central to avoiding adverse outcomes. For this reason, they should pay much attention to them.

Effective foot self-care may be possible by bridging the gap between patient and practitioner viewpoints on leg issues. When speaking with patients about foot care, medical practitioners should actively listen to what they have to say since the patient may infer from their interest level that the subject is important and should be given priority. The motives for behavior modification, such as making time each day to inspect one’s feet, should also be included in these conversations (Kerr et al., 2019). Diabetes is a latent illness, meaning that its diagnosis and management might be complex and require additional attention. Therefore, there is little reason to alter behavior based only on symptoms, particularly in the early stages of the condition. Instead, assumptions about health, such as how much of an influence diabetes has on everyday life, how well patients can manage their illness, and how successful preventative measures are, might alter behavior. With these factors in mind, a patient’s health views and desire to practice self-care for their feet should be evaluated before beginning any specific instruction.

Any educational program must allow for some degree of personalization to ensure nurses benefit from it and that their peculiarities are considered. Nurses might have various educational demands regarding their competence, level of knowledge, and experiences of working with patients with diabetic foot. It means that the educational programs on diabetic foot management should be aligned to the current unit’s needs, its results, and the most frequent problems impacting outcomes. For instance, assistance can be provided in terms of HRFTs to ensure all new members acquire the necessary toolkit and knowledge (Chan et al., 2020). It would reduce pressure on nurses and avoid burnout or issues linked to their schedules. In such a way, personalization is essential when training nurses to manage diabetic feet.

Furthermore, since poor foot care in people with diabetes can have significant repercussions, it is critical to emphasize the significance of timely and effective addressing of the problem. To avoid information overload, medical personnel must be trained following the existing schedules and their duties in the healthcare unit. The diabetic information package must include foot care instruction, but it must be delivered in a way that considers the nurse’s peculiarities and aptitude for learning new material (Pourkazemi et al., 2020). Numerous studies have demonstrated that an intense one-time teaching program or session following a diabetes diagnosis can result in better outcomes and minimize the risk of acquiring adverse outcomes (Ross, Lechleitner, and Obermann, 2021). To maintain these gains over time, it is essential to establish the continuity of training and education among nurses.

At the same time, organizational change to improve outcomes might also imply teaching patients. For this group, education is essential for preventing diabetic foot ulcers. Additionally, it is crucial for early detection and treatment. Patients with diabetes who get foot care training can better control their illness, lower their risk of infection, and avoid the need for amputation (Singh et al., 2020). In such a way, both patients and health providers should be knowledgeable about diabetic foot care. This is crucial for staff members who work in settings like hospitals, nursing homes, and neighborhood clinics where there may be diabetic patients. It also establishes the basis for better cooperation in the future.

In such a way, medical personnel must receive education on diabetic foot care since this will assist staff members in gaining the skills and knowledge necessary to offer patients with diabetes high-quality treatment. It aids employees in comprehending diabetic foot ulcer (DFU) causes, symptoms, treatments, and preventative measures (Valabhji et al., 2020). Patients can benefit from this information by taking charge of their health and lowering their chance of acquiring ADHD. Furthermore, healthcare personnel benefit from education since it enables them to recognize DFUs’ early warning symptoms. They can take precautions to lower the possibility of problems. They can swiftly direct patients to the proper care. Treatment of DFUs, halting disease development, and lowering the risk of amputation all depend on early intervention.

Healthcare personnel who have received training in diabetic foot care can appreciate the value of interdisciplinary treatment. Treatment for diabetic foot must be comprehensive, and a multidisciplinary team of experts is necessary for effective care. The management of DFUs may need the involvement of all podiatrists, wound care nurses, dietitians, and infectious disease experts. The staff must thoroughly understand each specialty’s contribution to the delivery of excellent medical care.

Compliance with UK Health Standards

Ensuring compliance with National Health Service (NSF) standards and other UK health laws is a crucial component of these diabetic treatment programs. NSF standards and other UK health laws play a crucial part in diabetes treatment programs. The United Kingdom Department of Health created the National Diabetes Service Facility (NSF) in 2001 (Kerr et al., 2019). To enhance patient results, NSF offers thorough advice on cutting-edge diabetes treatment techniques. The provision of high-quality, patient-centered care that emphasizes evidence-based practice and interdisciplinary care is required for diabetes care programs to achieve NSF requirements.

To execute preventative programs and identify people at high risk for the disease, NSF-designed primary care practitioners are essential. Strategies for preventing and identifying diabetes should be included in diabetic care programs. The NSF guidelines strongly emphasize the value of organized educational initiatives that teach persons with diabetes how to properly manage their illness (Ross, Lechleitner, and Oberlander, 2021). Diabetes complications, including foot, eye, and renal care, should be the main emphasis of diabetes care programs to avoid and manage them.

A crucial part in diabetic care programs is also played by UK health legislation in addition to NSF requirements. For instance, the UK government controls the production and marketing of medical equipment, such as insulin pumps and blood glucose meters, which are crucial for managing diabetes (Singh et al., 2020). The regulation of medical devices is under the direction of the Medicines and Healthcare Products Regulatory Agency (MHRA). Programs for diabetes care must make sure they adhere to legal criteria while offering patients safe and efficient treatment. In addition to regulating medical equipment, UK health legislation mandates that healthcare services uphold strong data privacy requirements and ensure patient confidentiality. Diabetes care programs must uphold data protection laws to safeguard patients’ privacy and maintain their medical records while delivering high-quality treatment.

Additionally, to enhance the results of diabetes care, NSF standards and UK Health Regulations support diabetes care programs in their adherence to evidence-based practice. Effective diabetes management requires the use of evidence-based practice. It entails fusing the best information available from the most recent studies and clinical practice recommendations, clinical expertise, and patient values and preferences (Valabhji et al., 2020). Evidence-based strategies must be used in diabetes care programs to deliver high-quality treatment and enhance patient outcomes.

Making sure that patients with diabetes are recognized early is the aim of Standard 2 of NSF. Diabetes can be identified and treated sooner and prevent complications from occurring if healthcare professionals and the public are more aware of the symptoms and indicators of the disease (Schmidt et al., 2020). Understanding symptom perception and results from studies on care-seeking behavior, including the effects of elements like delaying seeking assistance and downplaying threats, should serve as the foundation for good treatment. It will be crucial to implement this standard to comprehend the variables that affect how screening is seen and how it affects people.

Standard three implementation should be founded on a solid grasp of health communication and decision-making when creating training for health professionals to enable them to operate in this way. Understanding the different psychological aspects that support good self-management and treatment adherence in chronic illness should also be part of this effort. However, a sizeable minority of diabetics do not comprehend important aspects of their diabetes management for various reasons (Valabhji et al., 2020). A diabetes diagnosis can also result in poor psychological adjustments, such as self-blame and denial, which can impair adequate self-control, lower self-esteem, treatment resistance, and depression.

The goals of Standards 5 and 6 are to provide young people with diabetes with high-quality care and a seamless transition from pediatric to adult treatment. The goal of these criteria is to guarantee that the unique requirements of children and young people with diabetes are acknowledged and fulfilled, ensuring that they have the best care possible and can adequately manage their daily diabetes care as they approach adulthood (Kerr et al., 2019). Children and teenagers with diabetes go through all the regular ups and downs of physical, emotional, and social development. Their unique requirements within a family or family system, as well as the support provided by their parents or siblings as they transition from receiving their initial diagnosis as children to being independent, are crucial.

Numerous significant insights into how children perceive and respond to sickness, as well as how families manage illness, are provided by health psychology. There is an evident rise in understanding of the importance of the child’s personal experience and the knowledge that kids create accurate, useful models of the events connected to the disease. It becomes evident that children’s views about health and disease can vary at any age or stage rather than seeing a child’s developmental stage as the main predictor of such notions. It is possible to create health education campaigns and provide quality healthcare by using this information about children’s comprehension. Parents may and often do play a crucial role in establishing knowledge, encouragement, and behavioral habits (Kerr et al., 2019). It is vital to comprehend children as self-regulating persons who can make judgments and choices based on their perceptions of health risks and diseases rather than considering them as developing but flawed replicas of adults.

To comprehend children’s behavior in connection to health and sickness, it is important to consider the influence of the immediate as well as the larger social and cultural environment. The implementation of these guidelines will thus focus on creating interventions that address the operational aspects of diabetes care, offer a platform for support and assistance, and aid children, adolescents, and their families in better coping with and managing the condition. It is significant to highlight that psychological research suggests that health education programs should pay more attention to how young people perceive danger. Risk behavior may be significantly influenced by risk perception.

The standards mentioned above are the most evident and applicable to health psychology, but other standards undoubtedly have intriguing potential. Enforcing these crucial requirements is now a difficulty for diabetes services. Working across organizational and professional barriers is strongly advised and is defined by NSF Diabetes as one of the clinical goals that the healthcare service should initially concentrate on. Real innovation and explicit knowledge of how diverse specialists, including psychologists, may collaborate efficiently to produce the best possible health results are required to attain this aim. Diabetes, a disorder that is spreading like an epidemic worldwide, is one of the most costly and debilitating chronic diseases in modern healthcare. People with diabetes now have a rare chance, thanks to the National Diabetes Foundation, to receive the proper diabetic care. The level of funding implementation and the realization of research agendas will ultimately depend on NSF criteria.

The National Institute for Health and Care Excellence (NICE) also offers guidelines for improving outcomes. The nursing practice and education regarding the discussed problem can be enhanced in terms of the NICE guidelines. It implies preventing ill health, protecting good outcomes, and improving the quality of life (NICE, 2023). It means that the proposed training meets NICE primary criteria as it helps to reduce the risks of adverse outcomes and ensure that patients with diabetic feet will enjoy a high quality of life.

The education can also be aligned with integrated multidisciplinary pathways and working groups such as Trend-UK. It is a working group of diabetes nurses with diverse skills and backgrounds cooperating to address the problem and attain better outcomes (About us, n.d.). The project is essential for providing health workers with the knowledge they might need to address diabetic foot and diagnose it. Cooperation with the group can help to create effective education programs and implement them in practice.

Recommendations

Altogether, considering the information mentioned above, it is possible to recommend educating nurses about diabetic food and its management. The problem is prevalent and might result in the emergence and development of numerous complications. For this reason, interventions aimed at training and educating staff are critical. However, some barriers might impact the effectiveness of these interventions and their outcomes. These might include nurses’ resistance, burnout, lack of time, and the need for additional financing. The obstacles might be overcome by effective planning and personalizing the provided services to ensure nurses’ needs are considered. As a result, it would help reduce the treatment cost, improve results, and ensure higher client satisfaction levels, which is essential for the healthcare sector.

Conclusion

Diabetic foot management is an important aspect of the modern healthcare sector. The educational programs for staff should be adjusted to address patient requirements following British and worldwide standards, which will enhance treatment outcomes. Providing nurses with additional training is essential for reducing adverse effects and complication rates. For this reason, training and education are the core of modern healthcare and should be supported in various units. It will guarantee that the most effective and relevant measures are employed.

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