NUR131 Assessment Task 3: Research Poster on Foot Ulcer Prevention

This research poster investigates the effectiveness of patient education in preventing diabetic foot ulcers among type 2 diabetes patients. The study addresses the research question: Does patient education on medical adherence and foot care compared to usual care prevent the occurrence of diabetic foot ulcers? The methodology includes a literature review of articles from databases like CINAHL, PubMed, and Google Scholar, using the PICO framework for article selection. The results suggest the importance of patient education, though it may not be sustainable long-term. The poster concludes that patient education can be complemented by other interventions, and nurses need training in incorporating it into primary foot management. References are provided in Harvard style, and a summary table is included.

Poster title
Author/Authors
University of the Sunshine Coast
INTRODUCTION
• Foot ulcers are a major cause of limp loss and a
major problem among diabetes patients.
• There is limited evidence on the strategies for
enhancing foot care management among
diabetes patients and consequently reducing
recurrence and amputation.
• Patient education has been mentioned as a
strategy for preventing recurrence and
amputation.
• There is limited evidence to ascertain its
effectiveness.
• The study sought to address the following
research question:
In patients with type 2 diabetes (P), does patient
education on medical adherence and foot care
(I) compared to usual care characterised by
medication, diet and physical exercise (C)
prevents occurrence of diabetic foot ulcer (O)?
METHOD
• 3 articles acknoledge that patient edcation is effective in addressing the
development and recurence of foot ulcers (Adiewere ,2018; Rahaman, 2018;
Sekhar, 2018; Zheng, 2019).
• 2 articles demonstrate insufficiency of evidence to support patient education
in foot ulcer management Van Netten , 2016; Dorresteijn, 2014)
• Kaya (2018) cited that nursing education can enhance patient outcomes
RESULTS
DISCUSSION
CONCLUSION
REFERENCES
•There is evidence indicating the importance of patient
education in the prevention of diabetic foot ulcers
•Patient education is a short-term solution to improving foot
care, but may not be sustainable in the long-term.
•Patient education can be complemented by other interventions
including use of therapeutic footwear, and foot treatment.
•Nurses need to be trained about the incorporation of patient
education in primary foot management
•The articles included in the study were obtained from
various databases including CINAHL, PubMed,
EbscoHost, and Google Scholar.
•The articles included were published in the last five
years
•The PICO table was used as a search strategy for
identifying the articles.
.
Reference for image
1. Adiewere, P., Gillis, R. B., Imran Jiwani, S., Meal, A., Shaw, I., & Adams, G. G.,
2018, ‘A systematic review and meta-analysis of patient education in preventing
and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU)’,
Heliyon, vol.4, no.5. doi:10.1016/j.heliyon.2018.e00614
2. Dorresteijn, J. A., Kriegsman, D. M., Assendelft, W. J., & Valk, G. D., 2014,
‘Patient education for preventing diabetic foot ulceration’, Cochrane Database
of Systematic Reviews, vol.1, pp.1-55. doi:10.1002/14651858.cd001488.pub5
3. Gathu, C. W., Shabani, J., Kunyiha, N., & Ratansi, R., 2018, ‘Effect of diabetes
self-management education on glycaemic control among type 2 diabetic
patients at a family medicine clinic in Kenya: A randomised controlled trial’,
African Journal of Primary Health Care & Family Medicine, vol. 10, pp. e1–e9.
doi:10.4102/phcfm.v10i1.1762
4. Kaya, Z., & Karaca, A., 2018, ‘Evaluation of Nurses' Knowledge Levels of Diabetic
Foot Care Management’, Nursing research and practice, vol. 2018,
doi:10.1155/2018/8549567
5. Lazo-Porras, M., Bernabe-Ortiz, A., Sacksteder, K. A., Gilman, R. H., Malaga, G.,
Armstrong, D. G., & Miranda, J. J., 2016, ‘Implementation of foot thermometry
plus mHealth to prevent diabetic foot ulcers: study protocol for a randomized
controlled trial’, Trials, vol. 1, no. 1, pp. 206. doi:10.1186/s13063-016-1333-1
6. Rahaman, H. S., Jyotsna, V. P., Sreenivas, V., Krishnan, A., & Tandon, N., 2018,
‘Effectiveness of a patient education module on diabetic foot care in outpatient
setting: An open-label randomized controlled study’, Indian Journal of
Endocrinology and Metabolism, vol. 22 no. 1, pp. 74–78.
doi:10.4103/ijem.IJEM_148_17
7. Rasmussen, B. S. B., Froekjaer, J., Bjerregaard, M. R., Lauritsen, J., Hangaard, J.,
Henriksen, C. W., Yderstraede, K. B., 2015, ‘A Randomized Controlled Trial
Comparing Telemedical and Standard Outpatient Monitoring of Diabetic Foot
Ulcers’, Diabetes Care, vol. 38, no. 9, pp. 1723–1729. doi:10.2337/dc15-0332
8. Sekhar, M. S., Unnikrishnan, M. K., Vijayanarayana, K., & Rodrigues, G. S.,2018,
‘Impact of patient-education on health related quality of life of diabetic foot
ulcer patients: A randomized study’, Clinical Epidemiology and Global Health,
Vol. 7, no.3, pp.382–388. doi:10.1016/j.cegh.2018.07.009
9. Van Netten, J. J., Price, P. E., Lavery, L. A., Monteiro-Soares, M., Rasmussen, A.,
& Jubiz, Y., 2016, ‘Prevention of foot ulcers in the at-risk patient with diabetes: a
systematic review’, Diabetes/Metabolism Research and Reviews, vol. 32, pp.84–
98. doi:10.1002/dmrr.2701
10.Zheng, F., Liu, S., Liu, Y., & Deng, L., 2019, ‘Effects of an outpatient diabetes self-
management education on patients with type 2 diabetes in China: A
randomized controlled trial’, Journal of Diabetes Research, pp. 1-7.
doi:10.1155/2019/1073131
The table below shows a summary of the identified articles.
Study
No 1st author
(year) Article
design Evidence level
1 Adiewere
(2018) systemati
c reviews patient education prevent s the development
and recurrence of diabetes foot ulcers, and
amputation
2 Van
Netten
(2016)
systemati
c reviews No evidence demonstrates the effectiveness of a
single patient education session
3 Dorresteij
n (2014); RCT insufficient knowledge to indicate the patient
education alone can effectively clinically reduce
incidences of ulcers and amputations
4 Gathu
(2018) RCT education programs may have short-term
benefits, but limit the long-term benefits that
may be reaped from a comprehensive approach
5 Lazo-
Porras
(2016)
RCT •Reminders improve adherence of the patient to
daily home-based foot care measures
•messages to enhance self-management of
diabetes foot care
6 Rahaman
(2018); RCT patient education helps to prevent the
development and recurrence of diabetes foot
ulcers, and the sequent amputation
7 Rasmusse
n (2015); RCT There was no difference in associated with
amputation and foot ulcers among patients
using telemedicine and those using the standard
outpatient monitoring.
8 Zheng
(2019) RCT patient education prevent s the development
and recurrence of diabetes foot ulcers
9 Sekhar
(2018) RCT Patient education helps to reduce incidence of
foot ulcers, and the sequent amputation
10 Kaya
(2018) cross-
sectional
study
Nurses demonstrated adequate knowledge of
diabetic foot management, but do not use it
during patient care