CAHPO 2016. Workshop 4: Chris Pankhurst and Lawrence Ambrose
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Chief Allied Health Professions Officer’s Conference 2016 Workshop 4: Supporting self-care and behaviour change – Chair Linda Hindle Foot assessment and foot self-care app. Chris Pankhurst, Guy’s and St Thomas’ NHS Foundation Trust. Lawrence Ambrose. Lead Policy Officer, Society of Chiropodists and Podiatrists.
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CAHPO 2016. Workshop 4: Chris Pankhurst and Lawrence Ambrose
- 1. Diabetic Foot Screening Apps Developed in collaboration with:
- 2. Source: IDF Diabetes Atlas – Seventh edition
- 3. Current Background and Statistics • In UK 3.5 million adults diagnosed with diabetes • Estimated 550k undiagnosed –an increase of 120k compared to the previous year –an increase of 65% over the past decade
- 4. Aims • Two Apps 1. HCPs who perform diabetic foot screenings 2. People with diabetes
- 5. Aims (HCP) • To understand the importance of routine foot screenings • To understand how diabetes affects the feet • How to perform a quality diabetic foot screening • How to determine the patient’s risk status • Patient education • When & whom to refer to
- 6. Aims (Person with DM) • To understand the importance of routine foot screenings & how DM can affect the feet • What to expect from a quality diabetic foot screening • Understand what their risk status means • Patient education • Insert emergency contact details & future appts • To know when to seek advice
- 7. The Importance of Routine Foot Screenings • Foot complications are common in people with diabetes, with an estimated 5-7 % having current or previous foot ulceration • Foot complications are the most common cause for admission of the person with diabetes • Diabetic foot ulcers precede more than 80% of amputations in people with diabetes • After a first amputation, people with diabetes are 23 times more likely to have a further amputation as people without diabetes
- 8. Difference between a Diabetic foot screening and assessment: – Screening is a quick process that categorises people into mutually exclusive groups and will give a reasonable indication of the likelihood/risk of developing a diabetic foot complication – Assessment is a lengthier process by which a diagnosis is reached and treatment/management is initiated Screening v Assessment
- 9. How it works
- 15. When to Seek Advice People with diabetes should be encouraged to seek advice if the following are encountered: Walking becomes difficult Applying shoes becomes difficult
- 16. All or part of the foot becomes swollen The foot becomes noticeable red or has another unusual discolouration A part or all of the foot becomes much hotter than normal
- 17. There is a discharge of any kind from the foot There is an unusual smell The feet have open sores or blisters
- 18. General feeling of being unwell, with nausea, vomiting and high temperature General difficulty keeping blood sugar levels under control
Editor's Notes
- Welcome to the Diabetic Foot Screening School. This has been developed jointly by the following associations: The College of Podiatry The British Association of Prosthetists and Orthotists The London Foot Care Strategic Clinical Network
- This is a map of the World, showing both the current prevalence of people with diabetes and the estimated figure by 2040.
- Worldwide, 1 in 11 adults have diabetes (415 million). It is predicted that this figure will rise to 1 adult in 10 (642 million) by 2040 The number of people living with diabetes in the UK has tipped over the 4 million mark, according to new figures released by Diabetes UK, which includes 3.5 million adults who have been diagnosed This is an increase of 119,965 compared to the previous year and marks an increase of 65 per cent over the past decade. There are also thought to be 549,000 people with undiagnosed Type 2 diabetes.
- At the end of this training session, each one of you will have been provided information on the following: - Current background and latest statistics - To understand how diabetes affects the lower limbs (aetiology) - To understand the importance of routine foot screenings - How to perform a quality diabetic foot screening, including: History Visual inspection Vascular inspection Neurological inspection Footwear inspection - How to determine the risk status of the patient - Patient education - When to refer and who to make the referral to You will then have the opportunity of completing a Theory test followed by a practical examination to ensure you are able to display the competency required to perform a quality diabetic foot screening. On successful completion, you will be awarded with a certificate to demonstrate your theoretical knowledge as well as a practical competency in this area of care for people with diabetes.
- At the end of this training session, each one of you will have been provided information on the following: - Current background and latest statistics - To understand how diabetes affects the lower limbs (aetiology) - To understand the importance of routine foot screenings - How to perform a quality diabetic foot screening, including: History Visual inspection Vascular inspection Neurological inspection Footwear inspection - How to determine the risk status of the patient - Patient education - When to refer and who to make the referral to You will then have the opportunity of completing a Theory test followed by a practical examination to ensure you are able to display the competency required to perform a quality diabetic foot screening. On successful completion, you will be awarded with a certificate to demonstrate your theoretical knowledge as well as a practical competency in this area of care for people with diabetes.
- Currently, a person dies from diabetes every 6 seconds (5.0 million deaths), with 1 in 7 births affected by gestational diabetes throughout the world. Looking at the data available from the International Diabetes Federation, Europe has the highest prevalence of children with type 1 diabetes. It is quoted that 10 per cent of the entire NHS budget is spent on diabetes every year, 80 per cent of which goes toward treating the secondary complications (the vast majority of which are related to diabetic foot issues). This does not take in to account the cost of amputee rehabilitation and the lifelong care and management.
- Currently, a person dies from diabetes every 6 seconds (5.0 million deaths), with 1 in 7 births affected by gestational diabetes throughout the world. Looking at the data available from the International Diabetes Federation, Europe has the highest prevalence of children with type 1 diabetes. It is quoted that 10 per cent of the entire NHS budget is spent on diabetes every year, 80 per cent of which goes toward treating the secondary complications (the vast majority of which are related to diabetic foot issues). This does not take in to account the cost of amputee rehabilitation and the lifelong care and management.
- Currently, a person dies from diabetes every 6 seconds (5.0 million deaths), with 1 in 7 births affected by gestational diabetes throughout the world. Looking at the data available from the International Diabetes Federation, Europe has the highest prevalence of children with type 1 diabetes. It is quoted that 10 per cent of the entire NHS budget is spent on diabetes every year, 80 per cent of which goes toward treating the secondary complications (the vast majority of which are related to diabetic foot issues). This does not take in to account the cost of amputee rehabilitation and the lifelong care and management.
- Currently, a person dies from diabetes every 6 seconds (5.0 million deaths), with 1 in 7 births affected by gestational diabetes throughout the world. Looking at the data available from the International Diabetes Federation, Europe has the highest prevalence of children with type 1 diabetes. It is quoted that 10 per cent of the entire NHS budget is spent on diabetes every year, 80 per cent of which goes toward treating the secondary complications (the vast majority of which are related to diabetic foot issues). This does not take in to account the cost of amputee rehabilitation and the lifelong care and management.
- Currently, a person dies from diabetes every 6 seconds (5.0 million deaths), with 1 in 7 births affected by gestational diabetes throughout the world. Looking at the data available from the International Diabetes Federation, Europe has the highest prevalence of children with type 1 diabetes. It is quoted that 10 per cent of the entire NHS budget is spent on diabetes every year, 80 per cent of which goes toward treating the secondary complications (the vast majority of which are related to diabetic foot issues). This does not take in to account the cost of amputee rehabilitation and the lifelong care and management.
- Currently, a person dies from diabetes every 6 seconds (5.0 million deaths), with 1 in 7 births affected by gestational diabetes throughout the world. Looking at the data available from the International Diabetes Federation, Europe has the highest prevalence of children with type 1 diabetes. It is quoted that 10 per cent of the entire NHS budget is spent on diabetes every year, 80 per cent of which goes toward treating the secondary complications (the vast majority of which are related to diabetic foot issues). This does not take in to account the cost of amputee rehabilitation and the lifelong care and management.
- Within your delegate packs, you have the following: Glossary of useful definitions The full suite of patient information leaflets for people with diabetes Pan-London Referral Guide and Screening Tool which is a pocket-sized reference guide providing screening and stratification information and local contact details for Foot Protection Services and Multi-Disciplinary Teams in different boroughs across London. 10g monofilament Usage guide for your 10g monofilament with information regarding recognised and recommended retailers for delegates to be able to arrange ongoing provision as required Flyer for the Diabetic Foot Screening App, which we will discuss next
- Does anybody have any questions?