A Critical Evaluation of Care Plan for Diabetic Foot Ulcer - Essay Example

A Critical Evaluation of Care Plan for Diabetic Foot Ulcer Introduction The prevention of the surgical removal of the lower limb is the primary objective in any care plan for diabetic foot ulcer (DFU) thus is vital to actively plan for DFU. As stated in general DFU care plans, regular foot examination, avoidance of tension to the foot, and immediate foot wound treatment would be beneficial (Ogunlesi 2010). In order to attain, priority should be given on education, proper dissemination of information, and communication immediately after the detection of diabetes. According to earlier figures, prevalence of amputations caused by diabetes had been constantly declining (Ogunlesi 2010). According to Jacob (2011), this continuous development was credited to the exercise of inclusive procedure and practice and a multi-disciplinary treatment model in committed medical institutions. More significantly, general procedures for the prevention and cure of DFU should be formulated, implemented, and are incorporated into the current medical protocols and healthcare practices. The quality of care plan for diabetic patients, especially the elderly, should be enhanced to enable prompt diagnosis and treatment of DFU. The implementation of an aggressive social security process and increased availability and accessibility of inclusive expert care are imperative (Dunning 2009). This paper is a critical evaluation of a care plan for DFU. Critical Evaluation The most imperative preliminary procedure in the preclusion of DFU is regular and reliable foot examination. All nurses and other health care practitioners who tend to diabetic patients should be knowledgeable and experienced in the procedure of foot examination. Patients also have to be educated in self-care which could be performed regularly. Preventive practices have been reported to be financially advantageous and lessen numbers of amputation in DFU (Mulder et al. 2004). Yet, apparently, a forceful need is present to highlight the necessity of constant foot assessment as component of a care plan for patients with diabetes. The three most vital parts of foot examination involve the detection of plantar pressure points (e.g. calluses), peripheral vascular disease, and neuropathy (Clark 2004). Neurologic examination must focus on pinpointing anomalous sensations such as deadness, burning, and tingling. These components normally overlap with tremor, soreness, and prickling in the foot especially, the plantar exteriors of the heel and toes (Edmonds, Foster, & Sanders 2008). Sensory functions examination, according to Ogunlesi (2010), is carried out in most medical facilities in First World countries with the application of biothesiometer and 10g Semmes Weinstein monofilament, yet a vast number of health care practitioners in Third World societies still employ crude medical procedures which are less reliable and exact such as tuning fork to detect pulsation. The application of 10g monofilament and biothesiometer has been verified to be consistent and precise in diagnosing patients vulnerable to ulceration and to determine who may require primary-care-level podiatry care. Several of the measures of podiatric recommendation comprise history of amputation or ulceration and incapacity to sense the monofilament (Ogunlesi 2010). The understanding of proper care for the foot, as stated by Masharani (2008), had been reported to be directly affected by patient knowledge which consequently lessens the possibility of foot amputation and ulceration in patients with acute diabetes. Therefore, educating patient on the preemptive techniques against foot ulceration has to be integrated into the regular care plan both at home and in the hospital. Effort and time should be given to education, dissemination of information, and communication throughout medical sessions. It has been reported that self care enhances the quality of care plans for DFU. Patients should realize the importance of foot care which should involve regular diagnosis for fissures and pressure areas (Turner & Merriman 2005). Patients should also be trained to identify the indications of infections due to the fact that bacterial and fungal infections are prevalent in diabetes and normally prone to more acute and multiplying bacterial contagions if ignored (Ogunlesi 2010). Tension to the foot should be prevented because DFU is largely caused by tension from foot wears. The importance of preventing tension is most pertinent to skilled workers, like construction laborers (Ogunlesi 2010). Hence, suitable and protective foot wear may be imperative for these patients. Conclusions and Recommendations Patients have to be dynamically assisted in performing self-care. This can include regular examination of feet and knowledge of the indications of infection. Nevertheless, numerous patients prone to diabetic wounds will sustain other health problems like retinopathy (Edmonds et al. 2008), which should be considered and addressed. It may be important to encourage the participation of health care providers and family members in the self-care procedure. Training in dressing method is imperative (Dabelko & Decoster 2007) if the patient is nursing a foot ulcer. Accordingly, it is imperative that healthcare providers and patients identify the indications of infection and disintegration and constantly monitor for these when treating ulcers. Diabetic foot ulcers may be naturally neuropathic. The outcomes of neuropathy may be calluses and parched skin, particularly in the foot exposed to pressures from walking. Neuropathic ulcers will disintegrate with complications, with severe outcomes (Andersen et al. 2003). Hence it is vital to examine diabetic foot ulcers promptly and engage every multidisciplinary group member in their medication. Existing treatment services may offer physiotherapy to lessen stiffness and soreness, yet occupational treatment may not be accessible in less developed societies (Ogunlesi 2010). Hence, surgical removal of the limb has considerable negative consequences on the general diagnosis of diabetes. Without the wide-ranging treatment schemes and serious financial losses, the maintenance of the fundamental management of this issue, such as changes in nutrition, monitoring of blood sugar levels, and medication accessibility (Jacob 2011), become very complicated without a firmly positioned social security structure which may tender monetary respite. The threat of further fatalities and most importantly precipitate morbidity become unavoidably emphasized. Hence, health education and health support are important instruments for the mitigation of the threat of ulceration and finally preclusion of amputation in diabetic people (Sousa & Zauszniewski 2005). Community-based education initiatives and public services may be helpful in disseminating information on the causes and effects of DFU. Individuals should be informed of the risk factors of postponing needed health care with regard to the possibility of limb surgical removal. References Andersen, H., Arezzo, J., Baynes, J., Biessels, G., Gries, F., et al. (2003) Diabetic Neuropathy. New York: Thieme. Clark, M. (2004) Understanding Diabetes. Chichester, England: John Wiley & Sons. Dabelko, H. & Decoster, V. (2007) “Diabetes and Adult Day Health Services” Health and Social Work 32(4), 279+ Dunning, T. (2009) Care of People with Diabetes: A Manual of Nursing Practice. UK: Wiley-Blackwell. Edmonds, M., Foster, A. & Sanders, L. (2008) A Practical Manual of Diabetic Foot Care. UK: Wiley-Blackwell. Jacob, E. (2011) Medifocus Guidebook on: Diabetic Foot Ulcers. UK: CreateSpace. Masharani, U. (2008) Diabetes Demystified. New York: McGraw-Hill. Mulder, M., Small, N., Botma, Y., Ziady, L. & MacKenzie, J. (2004) Basic Principles of Wound Care. New York: Pearson Education. Ogunlesi, F. (2010) “Challenges of Caring for Diabetic Foot Ulcers in Resource-Poor Settings” The Internet Journal of Advanced Nursing Practice 10(2) Sousa, V. & Zauszniewski, J. (2005) “Toward a Theory of Diabetes Self-Care Management” Journal of Theory Construction & Testing, 9(2), 61+ Turner, W. & Merriman, L. (2005) Clinical Skills in Treating the Foot. UK: Churchill Livingstone. Read More