Diabetic foot

The impact of community teaching sessions on onward referral to specialist diabetic foot services (2023)

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Type of publication:Journal article

Author(s):Al-Saadi, Nina; *Beard, Nichola; Al-Hashimi, Khalid; Suttenwood, Helen; Wall, Michael; *Jones, Steven; Merriman, *Catherine

Citation:Primary care diabetes. 18(1):79-83, 2024 Feb.

Abstract:INTRODUCTION: Prompt referral of patients with diabetic foot ulceration (DFU) to specialist services can lead to more timely assessment of these patients and subsequent improved rates of limb salvage and patient outcomes. In this study we wanted to determine the impact of education in the primary care setting on onward referrals to our specialist Diabetic Foot multi-disciplinary team (MDT) clinic. METHODS: As part of a Diabetic Foot Roadshow, four teaching sessions were delivered in primary care settings across Shropshire by our specialist team from 17th March to the 25th May 2022. Attendees included podiatrists, tissue viability nurses, district nurses and wound care practitioners. Hospital records were used to identify all onward referrals to our Diabetic Foot MDT clinic in the weeks before and after delivery of the roadshow education sessions. RESULTS: 184 referrals were made to the diabetic foot clinic from January to July 2022. There were 0.3 referrals per day in the months prior to the commencement of the education sessions, compared to 1.5 referrals per day following the commencement of the teaching sessions. This increase in referrals was statistically significant (p < 0.0001). CONCLUSION: Teaching sessions delivered to community specialist healthcare professionals significantly increase onward referral of patients to specialist services, facilitating more timely assessment and management of patients with DFUs.

The diabetic foot: Get your patient on the right antibiotics! (2019)

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Type of publication:
Conference abstract

Author(s):
*Lefroy R.; Summerour V.; *McMullen K.; Corfield L.

Citation:
British Journal of Surgery; Sep 2019; vol. 106, S5, p. 165

Abstract:
Aim: The National Institute for Clinical Excellence has established evidence-based guidelines for the
management of diabetic foot infection. These follow basic principles of treating infections with broad spectrum
antibiotics until cultures provide more accurate guidance for antibiotic treatment. This audit aimed to assess
the practice of a tertiary vascular centre against this guideline, to bring in measures to improve practice and
then to re-examine this practice.
Method(s): Data was collected retrospectively for all patients who underwent an emergency operative
intervention for a diabetic foot infection under the care of vascular surgery (n=122). Data collection focused on
microbiological samples sent and antibiotics prescribed. The results were shared with the surgical unit and the
guidelines reiterated. A proforma was trialled and one month of patients with diabetic foot infection admitted
as emergencies were prospectively reviewed.
Result(s): Initially, we showed that only 36% had microbiological samples sent at the time of their procedure. Of these, almost half were on antimicrobial therapy not tailored to sensitivities. Following education and
instigation of our proforma, we demonstrated that 77% of patients had samples and improving rates of
appropriate antibiotic prescriptions.
Conclusion(s): Our data demonstrates significant improvement in these patients management. Doctors must
check sensitivities of samples to ensure antibiotic stewardship.

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