There are various methods and devices that can be used for pressure offloading in the diabetic foot. Diagram 1 summarises the advantages and disadvantages of specific devices that are used as offloading devices for the diabetic patient. Additional to this devices, surgery can be used for offloading. Surgery is used to stabilise and adapt the mechanism of the foot, thereby redistributing pressure over the plantar aspect of the foot.
In my practise I do not have great success with the use of walkers, crutches and wheelchairs. Although these aids provide complete offloading, the patient needs to have good upper body strength and good balance to use crutches and walkers. Slipping and falling is a huge risk and it can cause severe injury to the
…show more content…
Patients need to understand the use of these devices, the advantages and disadvantages and above all the reason why they have to use it.
I prefer to consult a podiatrist or prosthetist and work together with them as part of an interdisciplinary team to find the optimal pressure offloading solution for an individual patient. However I have learned a few hard lessons with referral to podiatrist and prosthetists as the result of a lack of knowledge and insight on the diabetic foot. They just do not understand the concept of offloading for diabetic foot abnormalities. If the Pedograph evaluation says ABC then that is how it is, they cannot accommodate the variables that are often associated with the diabetic foot.
I have had great success in treating diabetic foot ulcers with fibreglass TCC’s. Although I don’t apply it very often I have done various courses and workshops on the application of a TCC. It is a skill that I continue to develop and I enjoy it immensely. I still apply TCC’s under the supervision of a more experienced clinician. The TCC reduces oedema and if applied correctly distributes the pressure equal over the foot. (12)(P272) In my experience it improves the healing time
I will review RNAO’s Best Practice Guideline: “Risk Assessment and Prevention of Pressure Ulcers” – by September 26 (RNAO,
Currently health care facilities use individual, multi-component interventions, or series of interventions to prevent pressure ulcers. Either health care staff is not implementing these strategies into their patient’s care or some changes obviously need to be made. Interventions to prevent pressure ulcers consist of using the Braden Scale for initial and repeated skin assessments to determine the patient’s risks for pressure ulcers, specialized support mattresses, heel supports, and frequent repositioning for bed bound patients, encouraging mobility, moisture management, nutrition, hydration, and reducing friction or shear forces on parts of the body at increased risk for pressure ulcers (Sullivan & Schoelles, 2013).
Infection could be prevented by the use of prophylactic antibiotics just before the surgery. Patients who have diabetes have a greater risk of developing joint infections. The signs of infection include fever, chills, pain and swelling of the affected knee. To detect signs of infection early, the patient’s vital signs especially temperature should be monitored closely. It is also important to monitor the knee for any abnormal swelling or discharge. Nursing interventions include regular hand washing and the use of aseptic techniques when changing wound dressings. When joint infection happens they are treated with antibiotics. The patient may also require the drainage of any pus from the joint if there is any (Vera
According to the Registered Nurse (RN) Scope of Practice Position Statement, “the RN is responsible for providing safe, compassionate, and comprehensive nursing care to patients and their families with complex healthcare needs” (Texas Board of Nursing, 2011). Nurses often care for five to six patients at one time; therefore, in order to provide the best quality care, patients are often connected to monitoring devices such as, physiological monitors, venti...
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et al., 2014).
Thomas, D. R. (2001). Issues and dilemmas in the prevention and treatment of pressure ulcers: A
Since we will be going to the nursing home, it is imperative that we know how to correctly assist a client with their ambulation. To begin with, Ms. D demonstrated how to use a wheelchair, cane, and walker. We all practiced assisting each other with standing, sitting, and falling.
..., and as technology has improved, the machines have become smaller, portable and available for use at the patient's bedside.
Education on the use of risk assessment scales in practice is identified as a recommendation along with the continued use of nurses clinical judgment being used combined with a risk assessment tool. This, along with surveillance for complications, is very relevant when considering the diabetic foot. Living with foot ulceration has been linked to diminished wellbeing, quality of life and physical health in patients. Identification of the patient’s pain status is vital when treating patients with diabetic foot ulceration and addressing the challenges of either pain or no pain.
Its aim was to assess the 93-year-old stroke patient in his home after staying in the rehabilitation unit for six weeks. For mobility, the patient could walk independently with a walking stick both indoor and outdoor. He was given a 3-wheel rollator to facilitate his outdoor walking. The patient was able to transfer himself to the armchair and shower independently, as there were armrests on the chair and grab rails in the shower room. However, he found it difficult to get in and out of the bed and toilet.
4)Diabetes Self-Management Questionnaire (DSMQ) (AndreasSchmitt,AnnikaGahr,Norbert Hermanns, Bernhard Kulzer,Jorg Huber and Thomas Haak 2013,Health and Quality of Life Outcomes).
of medical devices are used by millions of health care providers around the world.” (Powell-
...uys out. In conclusion, a warning, technology is there to guide and help a physician it is not, nor has it ever been intended to replace the physician patient relationship.
Imre Nagy was born on June 7, 1896 in Kaposvar located in Hungary. He then joined the Bolsheviks in the Russian Revolution where he became a communist. His first job was working as a locksmith before joining the army in WWI, leading to him being captured in a prison in Russia and was charged for organizing the Hungarian people's democratic state. He escaped and joined the Red Army moving to Moscow in 1929. In 1953,after four months of stalin’s death, Imre Nagy became the new prime minister. In the Warsaw Pact, he removed Hungary and led them in the Hungarian rebellion against the soviets. In the 1956 revolt, the Soviets turned to Imre Nagy for guidance. He was now outstanding and respected by the Hungarian people. His last speech being broadcasted
Johnson, Michael. A. A. (1999) The 'Standard' of the 'Standard Is technology changing the doctor/patient relationship?”. Health Today, 11, 8 – 11. Mandl, Kenneth, MD., Kohane, Isaac, MD., Brandt, Allan, MD.