Answer 2 for NURS 8502 Week 2 Assignment 3 Identify a Gap in Practice

 Answer 2 for NURS 8502 Week 2 Assignment 3 Identify a Gap in Practice

The identified practice problem for the practicum project is Diabetic ulcer. Diabetic ulcer is a common diabetes complication issue that cuts across nursing practice and the healthcare profession in general. The issue is experienced not only in our healthcare organization but also in other organizations and patient care facilities globally.  Diabetic ulcer is one of the diabetic complications connected with major morbidity, mortality, and reduced quality of life and is one of the most serious diabetes complications (Lin et al., 2019). Besides, it is the major cause of foot amputations among diabetic patients. According to Adem et al. (2020), the global prevalence of diabetic ulcers in persons with diabetes mellitus is 6.3%. The highest incidence is in North America (13%), followed by Africa 7.2%, and the lowest in Europe (3%). Besides, about 15-25% of patients with diabetes mellitus develop a diabetic ulcer during their lifetime.

Numerous studies have been conducted to assess the efficacy of various interventions in preventing and treating diabetic ulcers to reduce the associated morbidity and high healthcare costs. The interventions that have been addressed by literature include glycemic control, patient education on foot hygiene, nail care, and proper footwear, wound debridement, and advanced wound dressings (Sulistyo, 2018). Despite literature proposing various interventions that healthcare professionals and patients can take to lower the incidence of diabetic ulcers, it persists to be a challenge for providers and is a significant burden on the healthcare system.

The management at the clinical site has taken several measures to address the diabetic ulcer issue. First, it has developed guidelines that require health providers to refer patients to a podiatrist annually for foot examination. It has also developed flyers containing information on foot care, which are given to diabetic patients. This is a preventive measure that aims at reducing the incidence of diabetic ulcers in the facility. However, the issue persists, and there is a need to evaluate other interventions that will help lower the prevalence of diabetic ulcers and the associated morbidity and mortality.

References

Adem, A. M., Andargie, A. A., Teshale, A. B., & Wolde, H. F. (2020). Incidence of diabetic foot ulcer and its predictors among diabetes mellitus patients at Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia: a retrospective follow-up study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 3703. https://doi.org/10.2147/DMSO.S280152

Lin, C. W., Armstrong, D. G., Lin, C. H., Liu, P. H., Hung, S. Y., Lee, S. R., … & Huang, Y. Y. (2019). Nationwide trends in the epidemiology of diabetic foot complications and lower-extremity amputation over an 8-year period. BMJ Open Diabetes Research and Care, 7(1), e000795. http://dx.doi.org/10.1136/bmjdrc-2019-000795