Improving timely referrals by implementing lower extremity amputation prevention tool in an suburban wound care clinic

Improving timely referrals by implementing lower extremity amputation prevention tool in an suburban wound care clinic

6^th International Conference on Wound Care, Nursing and Tissue Science
May 20, 2022 | Webinar

Azam Tayyebi

Frontier Nursing University, United States

Scientific Tracks Abstracts : J Trauma Crit Care

Abstract:

Background: Globally, every 30 seconds there is an amputation due to a non-healing diabetic foot ulcer (DFU) (Jabrink et al., 2017). Research shows prevention programs such as utilizing a lower extremity amputation prevention (LEAP) tool could reduce DFU complications. Local Problem: Impact DuPage (2013) reported that 8.1% of the DuPage population had diabetes, however 12% of the patients with diabetes have had no diabetic foot screening. At a clinic located in DuPage County, the charts audit for the second half of 2017 indicated 55% compliance with documentation of diabetic foot exams. Method: This quality improvement (QI) used four two-weeks plan-do-study-act cycles. Each cycle included tests of change (TOC) related to patient and team engagement, DFU screening, and referral for treatment. Data were analyzed using run charts and the impact of the interventions were measured. Intervention: Staff was engaged by a kickoff in-service, daily huddles, and weekly team meetings. A modified “Team Effectiveness Diagnostic” survey measured team engagement. Foot Care for a Lifetime was used as shared decision-making tool. Clinicians assessed patients with diabetes with the LEAP checklist and utilized referral log to track appropriate referrals. Results: At the end, patient and team engagement improved to 75% and 92% respectively; also all patients with DFUs were assessed by the LEAP tool (100%) and appropriate referrals (100%) were made. Conclusion: Team engagement was essential in the success of this QI. Patient engagement in the care of their DFU was empowering to patients. The team became better engaged with patients and patients reported more involvement in their own care. References 1. Alavi, A. et al. Diabetic foot ulcers: Part I: Pathophysiology and Prevention. Journal of the American Academy of Dermatology. 2014, 70(1) 2. Sloan FA et al. Receipt of care and reduction of lower extremity amputations in a nationally representative sample of U.S. Elderly. Health Services Research. 2010, 45:1740-1762. 3. Siersma V. Health-related quality of life predicts major amputation and death, but not healing, in people with diabetes presenting with foot ulcers: the Eurodiale study. Diabetes Care. 2014, 37(3): 694-700

Biography:

Azam Tayyebi is a wound and ostomy care specialist. As a hospice nurse at Vitas Healthcare from 2009 to 2012, performed many traditional nursing duties such as observing, assessing, and recording symptoms, and still worked closely with physicians, administered medications, and provided emotional support. Azam Tayyebi worked as a Telemetry nurse at St. Margaret's Health, where she cared for patients who needed extra monitoring, such as those who had recently been released from the intensive care unit. She is currently employed at Elmhurst Memorial Healthcare.

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