Different ways of delivering patient education and diabetic foot screening: A small test of change.

Caroline and Claire.jpgHello we are Claire and Caroline Podiatrists in NHS Lanarkshire.  We are blogging for the first time and would like to share our NES AHP Careers Fellowship project with you.

Through Claire’s doctoral studies at Glasgow Caledonian University we knew that people with diabetic foot ulcers often reported that they had no awareness of how serious a condition diabetes is.  They expressed regret at not having had information at the right time and not having changed some of their lifestyle habits. We wanted to make sure that this knowledge influenced podiatry service delivery. After all, we currently carry out diabetes foot screening as part of our clinical roles on a daily basis and these appointments are time consuming, repetitive, and often poorly attended.  We therefore decided to apply for a NES AHP Careers Fellowship to help us build on what people had told us and carry out a small test of change and service improvement.   We were delighted to be successful and are the first podiatrists from NHS Lanarkshire to gain a Fellowship.

The focus of the project is on self-care and preventing future complications from occurring.  We give advice and signpost people to local services such as North Lanarkshire Council’s Weigh-to-go free nutrition and exercise programme, and Quit your Way for smoking cessation.

The aim of our project is to provide a uniform educational presentation for people with newly diagnosed type two diabetes. All people are given the power point presentation as part of a group session with time for questions.  Then they have their foot screening carried out and are risk stratified as indicated by the SIGN guidelines. Everyone is given an information pack at the session to read and reflect on at a later time.

The advantages of this project are that all people are given evidence based standard advice and information that increases their awareness of diabetes and the possible complications.  We recognise that people are at different stages of readiness to change, so the timing of our intervention may not be at the optimal time for every individual.  However, the education pack can be used at a time when the person is thinking about making lifestyle changes.   There is a plethora of information available on diabetes, but it can be difficult for people to know how or if it relates to them and indeed how accurate it is.   The treatment and management of diabetes is a holistic approach where the patient is the most important member of the team as they carry out the day-to-day management of the condition.  Podiatry is here as part of this team to support with foot-related issues, education and signposting to other services that the patient may require.

We have received positive feedback from patients who have attended our sessions.  Our colleagues have also expressed an interest in becoming involved in the delivery of future sessions.  Another benefit to the way in which we deliver this intervention is that it frees up appointment slots so we can see people who urgently need podiatry intervention more rapidly.

Overall, we are happy with the way our project has progressed and been received.  We are enthusiastic about the potential for wider implementation and the use of digital health to help us connect with service-users to support them to live as full a life as possible.

For further information, please contact Dr Claire James or Mrs Caroline Graham at:  Claire.james@lanarkshire.scot.nhs.uk or Caroline.graham@lanarkshire.scot.nhs.uk

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