The Diabetic Foot putting the best foot forward Phyllis Camilleri - - PowerPoint PPT Presentation

The Diabetic Foot putting the best foot forward

Phyllis Camilleri Podiatrist Diabetes Foot Care

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TARGET

PATHWAY OF CARE FOR THE FOOT IN DIABETES

STAGE CARE NEED HEALTHY FOOT SCREENING- early detection

• f complications and risk

factor early intervention and education. presently done in secondary and primary care but not all stake holders aware. NATIONAL DIABETEIC FOOT SCREENING PROGRAMME IS NEEDED. REQUIRES MORE SPECIFICALLY DEDICATED, HUMAN RESOURSES ,EQUIPMENT AND SPACE. ONCE IN PLACE PATIENT AND HEALTH CARE PROVIDER AWARENESS CAN BE IMPROVED.

PATHWAY OF CARE FOR THE FOOT IN DIABETES

STAGE CARE NEED THE ‘AT RISK’ AND ‘HIGH RISK’ FOOT REGULAR PREVENTIVE CARE AND TIMELY OR IMMEDIATE INTERVENTION WHERE NECESSARY. Currently available with good liaising between professionals who are aware of services. Introduction of joint vascular clinics and vascular surgery has lead to improvement in limb salvaging. Improvements necessary:

• Appointments for further investigation.
• Budgetary and human resource limitations at

OPU.

• Investment in a CAD-CAM 3D scanner will

reduce timing of orthotic supply significantly.

Amputations

89 85 95 268 232 268 122 114 109 112 129 133 104 84 111 97 105 115 165 218 50 100 150 200 250 300 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Major Minor

Introduction of Vascular Surgery Service

PATHWAY OF CARE FOR THE FOOT IN DIABETES STAGE CARE NEED THE ULCERATED FOOT REGULAR PREVENTIVE CARE AND TIMELY OR IMMEDIATE INTERVENTION. Currently available with good liaising between professionals who are aware

• f services.

Improvements necessary:

• Provision of medications including dressings and antibiotics often

fraught with red tape and too much paper work. Not clear to practitioners what can be supplied.

• Faster OPU supplies are crucial at this stage.
• Problems with: timing of delivery and

site location of OPU not conducive to multidisciplinary liaising.

PATHWAY OF CARE FOR THE FOOT IN DIABETES STAGE CARE NEED THE AMPUTATED FOOT OR LIMB REGULAR REVIEW TO MONITOR LIMB STATUS AND PREVENTIVE CARE FOR STUM AND COLLATERAL LIMB. Services for good after care are currently in place and generally at this stage patients will be aware of quick access pathways to any of health care professions needed. Improvements needed:

• Better psychological after care.
• CPD programme for care providers re

teaching strategies.

• Unit for screening/monitoring amputees.

Thank you.