Seven hospital trusts in the region launched an education programme for staff, set a standard method of checking feet and improved the recording process for these checks. The doctors designed awareness raising posters for wards, arranged presentations for staff and promoted foot checks through social media.
The push for improved foot care services resulted in the number of patients on pilot wards with diabetes receiving foot assessments within 24 hours of admission increase from six per cent to 25 per cent in six months.
Good foot care is extremely important for people with diabetes to reduce their risk of developing serious foot problems. Each week in England there are more than 100 amputations in people with diabetes, 80 per cent of which are potentially preventable.
According to guidelines from the National Institute for Health and Care Excellence (NICE), all patients with diabetes http://www.nice.org.uk/guidance/index.jsp?action=byTopic&o=7239 in hospital should have a foot assessment during their stay.
A group of 15 specialist registrars were involved with the project from University Hospitals Bristol NHS Foundation Trust, Royal United Hospital Bath NHS Trust, Taunton and Somerset NHS Foundation Trust, Great Western Hospital NHS Foundation Trust, Gloucestershire Hospitals NHS Foundation Trust, Weston Area Health NHS Trust, and North Bristol NHS Trust.
Clinical research fellow, Chrysoula Papastathi, from University Hospitals Bristol NHS Foundation Trust, who led the research, said that the quality, as well as frequency, of footchecks was improved by the project.
She said: “We were aware of the disappointing data from the NHS on the incidence of amputations in the South West. We were confident that with the right checks in place foot problems can be detected early and managed, and that raising awareness among healthcare staff about the importance of foot checks would be the best way forward.
“While we were pleased to see an increase in the number of patients receiving foot checks, there is still a long way to go. We have shown that with limited resources, and with strong collaboration and determination, we can influence people over a large geographical area and pave the path for a bigger campaign to improve the quality, as well as the frequency of footchecks. It was an ambitious project and we all hope that further action builds on our progress.”
Phaedra Perry, Diabetes UK South West Regional Manager, said: “We are pleased that this team of doctors has led on improvements to footcare for people with diabetes in hospitals. It is great that more people are receiving good quality checks which could pick up potentially serious problems with their feet. But we really hope that the work they have started will lead to more people receiving this vital check in the future, as every patient with diabetes should have their feet checked while they are in hospital.
“It is so important as people with diabetes are 30 times more likely to have an amputation compared to the general population, and having an amputation has a devastating impact on quality of life. We hope that by implementing this new approach permanently will help to avoid unnecessary amputations.”
The Diabetes UK campaign, Putting Feet First, http://www.diabetes.org.uk/putting-feet-first aims to reduce diabetes-related amputations across the UK. As well as raising awareness among people with diabetes of the importance of good foot care, it is also demanding that the NHS improves the systems it has in place to treat foot problems.