Educating Nurses in the Care of Diabetic Foot Ulcers

Running head: EDUCATING NURSE IN THE CARE OF DIABETIC FOOT ULCER
EDUCATING NURSES IN THE CARE OF DIABETIC FOOT ULCERS
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1EDUCATING NURSE IN THE CARE OF DIABETIC FOOT ULCER
Literature review
The aim of the present study is to critically analyse the importance and necessity of
educating nurse in the care of diabetic foot ulcer. In today scenario of UK, diabetic foot ulcer is
the most lethal disease whose treatment is limited because of financial, economic, politic social
factors. As the mean of giving care, nurses of UK are the mainstream of alternative approach of
treatment of foot ulcer. The present research will focus on the skills, potential and education of
the nurse in providing care to the patient suffering from diabetic foot ulcer.
The problem of rising prevalence of diabetes is bringing a concomitant increase in its
consequence and complication among the person suffering with Diabetes. The most common
concern of diabetes is foot ulcer. Research by Lim, Ng and Thomas(2017) on prevention of foot
ulcer stated that incidence of diabetes among the people of UK is estimated to be 3.6 million and
expected to rise to 5 million in next 10 years. In UK the major health problem linking to single
reason for high hospitalization among the people suffering from diabetes is diabetic foot ulcer.He
further concluded by saying that preventative method for such disease is by patient education and
regular assessment of symptoms that can be the basis for management of foot ulcer.Ogurtsova
(2017) stated in his study that by 2040, the total rise in diabetic patient will increase by
10.4%.Walsh et al. (2016) investigated the prevalence of diabetic foot ulcer and death by using
hazard model from 414523 diabetic patient and founded that 5% of people with early foot ulcer
died within 1 year and 42.2% of people with chronic foot ulcer died within 5 years of period.
Therefore, it can be said that diabetic foot ulcer is recognized and linked to high risk of death and
should be taken as warning sign. Evidently, diabetic foot ulcer complication in latter stage is
linked with serious morbidity and lower the quality of life. It is noted from the research that more
than 75% of non-traumatic limb amputation is because of diabetic ulcer (Lombardo et al. 2014).

2EDUCATING NURSE IN THE CARE OF DIABETIC FOOT ULCER
Looking into the physiology of disease, the common cause of development for foot ulcer
are low glycaemic level, peripheral neuropathy, vascular disease and suppression of immune
system. Alavi et al (2014) said that about 85% of the foot ulcer is because of peripheral
neuropathy that alter the foot pressure. There are various deadly reasons that people are not
focusing in reduce its risk of occurrence. Negligence of patient are seen in the research
ofHemmati et al. (2017). People of United Kingdom have rich diet which result in high blood
glucose level. With rise in ignorance of proper care, peopleare facing the issue of diabetes at a
very high risk of foot ulcer. Therefore, Patient need to know about prevention and management
of diabetes as highlighted in the study of Coppola et al. (2016).
From the study of Armstrong, Boultonand Bus (2017) has mentioned in hisresearch that
northwestern United Kingdom has prevalence of the diabetic foot ulcer of 1.7% annual incidence
of 2.2%. the author has studied the diabetic foot ulcer and their reappearance in which he stated
that approx. 40% of the patients face the situation of recurrence in 1 year, 60% in 3 years after
ulcer get heals. Therefore, he concluded by saying that prevention of diabetic foot ulcer can be
by controlling diabetes in UK, educating nurse of UK to manage the illness and surgical
intervention by the health professional.
Hasan et al. (2016) tested the safety of intensive and less intensive glycemic control in
inhibiting diabetic foot ulcer. In the paper they stated that on the basis of United Kingdom
Prospective Diabetes Study, intensive control of glycemic has adequate effect on the frequency
of microvascular complication in diabetic foot ulcer patient. The author highlighted intensive
therapy given by nurse as another area to manage ulcer. Therefore, author concluded that giving
training to nurses and educating them will be the best way out for the disease.

3EDUCATING NURSE IN THE CARE OF DIABETIC FOOT ULCER
However, with poor control of the disease the complication of it rising as the major
public health issue. They are become the leading reason for hospital admission, amputation and
high rate of mortality in patient suffering from diabetes. In the study of Ahmad (2016) seen that
foot ulcer in patient in addition high occurrence of pain and morbidity, is creating substantial
burden and low socio-economic outcome. Previously it is stated the cost for managing the care of
foot ulcer is high and its one of the major reason for its complication in health sector.
Guest,Fullerand Vowden (2018) estimated the care plan and health resource for
managing diabetic foot ulcer in clinical practice by National Health Service. He said that cost of
intervening unhealed ulcer is 4 times high than healed ulcer. He added that the cost may get
affected by the by combination of factor like high amputation rates, its morbidity and mortality,
poor control of diabetes.In order to manage the disease, it require huge investment and create
burden in the society. From the study of Kerr, Rayman and Jeffcoate (2014) it has been noted
that the procedure to manage the diabetic foot ulcer with help of resource and medication has
pose a high socio-economic burden. The author in his paper has estimated the total cost for 580
pound million to the National Health ServiceUnited Kingdom out of which 50% are spent in the
care of foot ulcer. Van Netten et al. 2016 conducted research through systematic literature review
regarding the prevention of ulcer in diabetic patients which is essential to reduce the burden of
the disease on patient as well as health resource. The author suggested that use of self-
management and nursing intervention for prevention of foot ulcer is strong enough to prevent the
disease. With the help of nursing assessment and education the patient will be able to self-
manage the disease efficiently.
From the annual report of Statista United Kingdom (2018) majority of the nurses with
285000, are working for National Health Service in 2018. Low number of nurse in UK is the