Posts Tagged ‘Diabetic Education’

Diabetic Footwear: If The Shoe Fits, Wear It

Friday, April 29th, 2016

When it comes to diabetic wound care, footwear matters – and proper diabetic patient shoe assessment is key.

Diabetic Footwear

 

Wound clinicians know how devastating foot amputations are for diabetic patients. But what you might not know is that a whopping 50% of diabetic foot amputations are a direct result of patients wearing improper footwear. Surprised? Unfortunately, this staggering statistic is accurate. But the good news is that there’s something we can do about it. If we get diabetic patients to wear the proper shoes, we can cut diabetic foot amputations in half.

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Diabetic Ulcers – Identification and Treatment

Monday, October 27th, 2014
Gail Hebert RN, BS, MS, CWCN, WCC, DWC, OMS, LNHA, Clinical Instructor

Gail Hebert RN, BS, MS, CWCN, WCC, DWC, OMS, LNHA, Clinical Instructor

Don’t miss this energetic webinar brought to you by Wound Care Education Institute®:  Another popular session recorded from the Wild On Wounds National Conference and providing continuing education credit.

Chronic foot ulcers in patients with diabetes cause substantial morbidity and may lead to amputation of a lower extremity and mortality. Accurate identification of underlying causes and co-morbidities are essential for planning treatment and approaches for optimal healing. In this one-hour recorded session, Gail Hebert will review evidence-based approaches for identification and treatment of chronic neuropathic, neuro-ischemic and ischemic diabetic foot ulcerations.

Wound Care Education Institute is featuring various webinars on topics from this years’ conference.  TO REGISTER CLICK HERE or visit www.wcei.net/webinars.

 

Trimming Those Tricky Diabetic Toenails

Thursday, March 7th, 2013

diabetic blog pic

You are getting ready to trim your diabetic patients toenails.  What exactly does that all involve?  Well, first you need the proper tools.  A set of toenail nippers, nail file, and orange stick are typically used.   Always follow your facility or healthcare’s settings policy for infection control.  Single use disposable equipment is favorable.

You have gathered your equipment to trim the patients toenails, now what?  Nails are easiest to trim after a bath or soak for 10min to soften nails.  The soaking of diabetics feet should only be done by a healthcare professional. You can clean under the patients toenail with an orange stick (wearing gloves), wiping on a clean washcloth in between each toe during soaking. .

After soaking and washing of the feet are completed, dry the patients feet completely.  Wash your hands and put on gloves to trim the toenails.  Use your dominant hand to hold the nipper.  Start with the small toe and work your way medial toward the great toe.  Squeeze the nipper to make small nips to cut along the curve of the toenail.  Be careful not to cut the skin.  Use your index finger to block any flying nail fragments.  Nippers are used like a pair of scissors – make small cuts, never cut the nail in one clip all the way across the nail.  Never use two hands on the nipper.  The nail is trimmed in small clips in a systematic manner.  The nail should be cut level with the tips of the toes, never cut so short or to break the seal between the nail and the nail bed.  The shape of the nail should be cut straight across and an emery board should be used to slightly round the edges.  When filing nails always use long strokes in one direction, avoid using a back and forth sawing motion.

When all toes have been trimmed and filed, remove gloves and wash hands.  Apply clean gloves and apply lotion to the top of the foot and to the soles of the feet, rubbing lotion in well, wipe excess lotion off with a towel.  Put patients socks and shoes back on as needed.  Wash hands and smile, you are done!

For your patients who are trimming their own toenails at home teach them the following simple instructions:  Be sure you have good lighting. Trim toenails after bathing, dry feet well, especially in between the toes.  Start with the little toe and work your way into the great toe.  Use small cuts, never cut the toenail across all at once.   Cut straight across and use a nail file to smooth edges.  Apply lotion to the bottom and tops of the feet, never in between the toes.  For patients with thickened toenails or yellowed toenails, recommend a foot care specialist like a podiatrist cut their toenails.

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Prevention, Prevention, Prevention

Wednesday, October 28th, 2009
Turning and Repositioning

Turning and Repositioning

To most of us in the Health Care industry, nursing in particular, it is obvious that the best ways to heal wounds is to prevent them in the first place. Sometimes however, that is not so obvious to members of the health care team that care for our patients both young and old and in-between. There are many reasons that can be attributed to that ignorance but that is not the reason for this post. That ignorance can be addressed through further education.

Lets discuss prevention of ulcers and wounds. Assessment of our patients needs is one way to initiate preventative measures. I was reading an article and commentary on Catherine Ratliff, Ph.D., from a meeting at the National Pressure Ulcer Advisory Panel in Arlington, VA

She recommended that caregivers assess four factors to determine an individual’s risk for heel pressure ulcers: age older than 70 years, diagnosis of diabetes, decreased mental status, and lack of movement in the legs and feet. Also, consider whether individuals are ambulatory, walk with assistance, or are confined to bed, she said.

Caregivers should take some precautions to prevent heel pressure ulcers even in individuals who are at low risk, Dr. Ratliff said. Check the circulation in the affected area, check whether the skin is warm or cool to the touch, examine the feet for redness, and apply moisturizer to the heels. Encourage individuals to get out of bed at least three times a day if possible. If that doesn’t happen, consider a pressure-redistributing mattress.

Individuals who are at higher risk, or those who already have a heel pressure ulcer, require stricter interventions, she said. Assess the patient and apply moisturizers more often, work hard to get the individual mobile, and perhaps use devices that take pressure off the heels.

You can read the rest of the article here .

What else can we do to assist preventing wounds from developing on our patients? As Wound Care Certified professionals, we can educate the public before and after they become our patients. Writing articles and submitting them to the web via blogs, making videos that speaks to our knowledge about prevention of wounds is an area that we can improve upon. Diabetic screening and education can be another example of how we can possible prevent development of ulcerations. For example we could do more foot examinations as part of a community outreach. All individuals with diabetes should receive an annual foot examination to identify high-risk foot conditions. This examination should include assessment of protective sensation, foot structure and biomechanics, vascular status, and skin integrity. People with one or more high-risk foot conditions should be evaluated more frequently for the development of additional risk factors. People with neuropathy should have a visual inspection of their feet at every visit with a health care professional.

Skin and Wound Manual

Skin and Wound Manual

A great resource for any Wound Care or Health Care Provider is the Skin and Wound Resource Manual Use the resources that are available to you. Teach the people you care for to take care of themselves before and when they develop wounds. Prevention of the wound prior to it develops is the best way to heal it!

For more information about becoming Wound Care Certified, please visit http://www.wcei.net