Clinical resources for diabetic foot health: applying the Wounds Canada Foot Health Pathway in Newfoundland and Labrador

Hunt, Ashley (2022) Clinical resources for diabetic foot health: applying the Wounds Canada Foot Health Pathway in Newfoundland and Labrador. Practicum Report. Memorial University of Newfoundland. (Unpublished)

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Abstract

Background: Newfoundland and Labrador (NL) has one of the highest incidences of diabetes and diabetes-related lower-limb amputations (LLAs) in the country, which has long-term implications for patients, families, health care providers (HCPs) and health systems. Despite the widespread prevalence of LLAs in NL, an organizational-level approach to address diabetic foot management is lacking. The aim of this practicum project was to develop a comprehensive clinical resource for HCPs to reduce diabetic foot complications and improve outcomes for patients living with diabetes in NL. Methods: Integrated literature review, consultations with key informants, environmental scan to determine existing resources, and development of a joint clinical resource for diabetic foot health. Results: The literature supported that diabetic foot ulceration (DFU) and LLA is a problem with negative implications for patients, HCPs and health systems and provided evidence in support of clinical pathways (CPWs) as an organizational level strategy to address DFU. The environmental scan illuminated the widespread availability of CPWs in jurisdictions outside of NL and highlighted the usefulness of the CPW developed by Wounds Canada in directing the provision of care. The consultation phase shed light on the complexity of diabetic foot management and allowed for the identification of specific needs of HCPs within a local context. Cumulatively, these findings informed the development of a clinical resource for the diabetic foot that aligns with evidence-based practice and the local needs of providers. An infographic was developed for local HCPs to support the application of the Wounds Canada (2022) Foot Health Pathway for People Living with Diabetes. The Wounds Canada CPW is designed to assist HCPs to systematically prevent, screen, detect, and treat diabetic foot concerns based on assessment of risk. A custom button was also developed as a secondary strategy to improve foot screening on an individual-level. Conclusion: A joint organizational and individual level strategy consisting of an infographic tailored to the local context of NL and a custom button for providers may be effective in assisting HCPs with application of the Wounds Canada CPW and in turn, improve diabetes outcomes in the NL. Key terms: Diabetes, diabetic foot ulcers, lower-limb amputations, care pathway, health care provider, management, organizational-level, individual-level, quality improvement, infographic, button.

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