Overview of Diabetic Foot Care for the Nurse Practitioner

Woody, Jennifer

doi:10.1016/j.nurpra.2019.08.011

Cited by 14 publications

(12 citation statements)

References 15 publications

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“…The total number of debridements was calculated for states (including DC) by NP practice authority category (ie, NPs have practice authority or do not have practice authority) for each year, as well as the mean debridements per state. Because NPs occasionally perform this procedure, 16 we also calculated the percentage of debridements performed by NPs in each state for each year. We then used Student's t tests to examine whether the mean debridements and mean percentage of debridements performed by NPs are statistically different between states with and without NP practice authority and between 2016 and 2017.…”

Section: Methodsmentioning

confidence: 99%

“…Foot ulcers afflict as many as 1 in 4 diabetic patients—the vast majority with type‐2 diabetes mellitus—and represent 33% of the economic cost of diabetes 11–13 . Patients with diabetic foot ulcers experience significantly higher mortality risks than other diabetes patients and a quarter of foot ulcers will never heal—with 10% ultimately requiring an amputation 14–16 . There are several treatment options available depending upon the severity of the ulcer.…”

mentioning

confidence: 99%

“…There are several treatment options available depending upon the severity of the ulcer. Because diabetic ulcers are typically at pressure points on the bottom of the foot, primary care providers usually treat less severe ulcers with standard wound management protocol and the utilization of specialized footwear and casts to keep weight off the healing foot 11,16 . Should the ulcers advance to a more severe state, the standard treatment is to undergo foot debridement, which is the excision of damaged, infected, or dead tissue to facilitate healing, usually by a specialist.…”

mentioning

confidence: 99%

“…[11][12][13] Patients with diabetic foot ulcers experience significantly higher mortality risks than other diabetes patients and a quarter of foot will never heal-with 10% ultimately requiring an amputation. [14][15][16] There are several treatment options available depending upon the severity of the ulcer. Because diabetic ulcers are typically at pressure points on the bottom of the foot, primary care providers usually treat less severe ulcers with standard wound management protocol and the utilization of specialized footwear and casts to keep weight off the healing foot.…”

mentioning

confidence: 99%

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Nurse practitioner scope of practice and the prevention of foot complications in rural diabetes patients

Hughes

Filar

Mitchell

2021

The Journal of Rural Health

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Purpose: Diabetic foot ulcers afflict a quarter of type-2 diabetes mellitus patients and are associated with higher mortality rates among people with diabetes. Routine primary and preventive care is essential to both prevent and treat foot ulcers before they can contribute to further adverse outcomes. One approach for expanding this care to people with diabetes in rural communities is increasing the practice authority of nurse practitioners. This study examines whether the presence of nurse practitioner practice authority is associated with fewer foot ulcer complications in rural populations as measured through the incidence of foot debridement-a common procedure for addressing severe diabetic foot ulcers.Methods: This study uses medical claims to estimate the incidence of foot debridement for US counties. A multivariable linear regression was performed to examine the association between nurse practitioner practice authority and the county incidence of foot debridement after adjusting for measures of local health care workforce and sociodemographics.Findings: Nurse practitioner practice authority was associated with 219.4 fewer foot debridements per 10,000 enrollees (P < .001) in rural counties. Rural health clinics (P < .03) and skilled nursing facilities (P < .03) were also associated with fewer rural debridements. The number of nurse practitioners (P < .69) and primary care physicians (P < .69) per enrollee were not significant. No measure of health care workforce was associated with the incidence of foot debridement in urban counties. Conclusions:Expanding nurse practitioner practice authority may be an effective solution for preventing complications from diabetic foot ulcers in rural communities.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Nurse practitioner scope of practice and the prevention of foot complications in rural diabetes patients

Hughes

Filar

Mitchell

2021

The Journal of Rural Health

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“…The other factors that mayin luence wound healing are generallyusefulfor the development of strategy, also a routine application as predictors of the outcome in patient management. "Modi ication of the modi iable factors, such as better control of diabetes, treatment of peripheral neuropathy, and early management of ulcers, may improve the outcome and facilitate healing" (Marzoq et al, 2019) "The degree of perfusion required for healing of a diabetic foot ulcer is affected by ulcer size, location, depth, infection, and nutritional status of the patient" (Woody, 2020) .The local care of foot ulcer usually commences from taking full history with a complete physical examination.Local care for diabetic foot ulcers should begin with a complete history and physical examination.The patient ought to be followed, and wounds estimated routinely for about a month.…”

Section: Introductionmentioning

confidence: 99%

Estimation of percent wound area reduction over a period of four weeks among diabetic foot ulcers

Jayalakshmi

2020

ijrps

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Foot ulcers are the most commonly experienced,fearful complications of diabetes which can frequently be life or limb-threatening.Several factors can lead to the occurrence of foot ulcers in diabetics.Prevention and proper management of DFUs are the prime most important in the care of patients with diabetes. It is essential to predictthe wound healingtime in managing the diabetic foot ulcers.The main objective of the study is to examine the reduction in wound area over four weeks in achieving more than 50 % Percentage Area Reduction (PAR) as a clinical outcome.Twowound irrigation methods were used for irrigating the wounds. Assessment of the wound area was done and comparedon achieving more than 50 % reduction in ulcer area at the end of four weeks. The studyused a descriptive comparative design with a control group. DiabeticFoot ulcerpatients (N = 160) from a private hospital were randomly allocated into 80 in each group (Neem solutionirrigation and Normal saline irrigation groups). In both groupsSurface area of the wound was measured using a disposable wound ruler with standard calibrations at baseline and then at the end of each week till four weeks are completed. Data were analyzed in SPSS20 software while considering p< .05 as statistically significant.The mean Wound surface area of the Normal saline group was 18.41 at the end of the first week and 14.04 after four weeks verses 19.84. The above-quoted scores in the Neem solution irrigation group were 14.68 and 6.92, respectively, against 17.13(p < .05).At the end of 4 weeks, the mean per cent reduction in area from baseline of DFUs irrigated with Neem solution was 72.4 % and with Normal saline was 48.7 %. Ulcers irrigated with neem solution had a 28.7 % greater mean reduction in area from baseline when compared with the normal saline control group at the end four weeks (p<.05).

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A Descriptive Study of Spiritual Well-Being and Foot Care Practices Administered to Turkish Patients Diagnosed with Type 2 Diabetes

Burucu

Güngör²

2023

J Relig Health

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Overview of Diabetic Foot Care for the Nurse Practitioner

Cited by 14 publications

References 15 publications

Nurse practitioner scope of practice and the prevention of foot complications in rural diabetes patients

Nurse practitioner scope of practice and the prevention of foot complications in rural diabetes patients

Estimation of percent wound area reduction over a period of four weeks among diabetic foot ulcers

A Descriptive Study of Spiritual Well-Being and Foot Care Practices Administered to Turkish Patients Diagnosed with Type 2 Diabetes

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