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The DIAFOOT Project: developing and implementing an evidence based acute diabetic foot care bundle

The DIAFOOT Project: developing and implementing an evidence based acute diabetic foot care bundle

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The DIAFOOT Project: developing and implementing an evidence based acute diabetic foot care bundle

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  1. The DIAFOOT Project: developing and implementing an evidence based acute diabetic foot care bundle Dr Nida Chammas Clinical Lead DIAFOOT project NIHR CLAHRC NW London February 2014

  2. N Chammas

  3. Background • 15% of diabetic patients will develop a diabetic foot ulcer • Lifetime risk is 25%

  4. 20% of diabetic admissions to hospital due to foot problems • Total expenditure on inpatient care for foot ulceration and amputation in 2010–11 is at £257 million. 11

  5. Diabetic foot ulcers precede >80% of amputations in Diabetic patients (100 people per week)

  6. Mortality DFU patients have 2.4 times the mortality rate of non-ulcerated diabetic patients.

  7. Financial Impact £700 million per year in England

  8. E Ramhamadany

  9. Nida Chammas Khalid Ahmed Professor Edmonds DIAFOOT Project £104,000 Essam Ramhamadany CLAHRC Sandra Wilson NICE

  10. THE DIAFOOT PROJECTfunded by NIHR CLAHRC NW London £104,000

  11. AIM To implement the current national guidelines for inpatient management of acute diabetic foot problems • NICE guidelines 2011 • Diabetes UK ( Putting Feet First)2009

  12. Sandra Wilson

  13. Junior Drs Dan Brown Patients Nida Chammas Diabetic Foot care bundle CLAHRC Team Elaine Hui Sandra Wilson Khalid Ahmed Essam Ramhamadany

  14. C Stacey

  15. C Stacey

  16. N Chammas

  17. Results • Implementation for 60 consecutive weeks (December 2011 to January 2013) • 991 patients screened • 254 (25.6%) identified as potential DF disease. • 99 (38.9%) patients assessed by a doctor. • 50% of patients had signs of ulceration; 43% had at least two or more signs of DF

  18. Summary Approximately one thousand patients were screened and nearly 1 in 10 patients identified as positive for acute DF disease were assessed by a doctor. This demonstrates that a significant proportion of admissions were influenced by this quality improvement project.

  19. Conclusion The DIAFOOT project represents a service improvement model, promoting new strategies for implementation of evidence-based practice.