Diabetic Foot Ulcers Among Diabetic Patients essay

Diabetic Foot Ulcers Among Diabetic Patients essay

Prevalence Of Diabetic Foot Ulcer

Problem statement

A diabetic foot ulcer is a poorly healing wound around the feet. It is the most common complication of diabetes mellitus in the United States of America. It has significantly contributed to mortalities and morbidities. Globally, around 26 million people are affected by diabetic leg ulcers. Diabetes is a chronic metabolic syndrome characterized by persistently elevated blood sugar levels. The most common cause of diabetes in modern society is poor lifestyle habits such as consuming highly processed calories and physical inactivity (Tilg, et al, 2017). Therefore, it causes insulin resistance and insufficient production of insulin. Diabetic Foot Ulcers Among Diabetic Patients essay

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A diabetic foot ulcer is the most common cause of non-traumatic amputations of the lower extremities. They are the leading cause of prolonged hospitalization compared to other complications of diabetes mellitus. Causes of diabetic foot ulcers are poor glycemic control, peripheral vascular disease, poor foot care, and neuropathy (Armstrong, et al, 2017). Development of the diabetic foot ulcer occurs in three stages; callus neuropathy, motor neuropathy, and autonomic neuropathy. Continuous trauma to the callus causes a subcutaneous hemorrhage and eventually an ulcer. Slow healing of a diabetic leg ulcer is usually due to atherosclerosis of the small peripheral blood vessels that lead to vascular compromise. Other causes of slow healing of diabetic ulcers are poor wound cleaning and dressing techniques and uncontrolled hyperglycemia.

Interventions

Due to the increased rate of diabetic foot ulcers and their associated complications, healthcare providers have strategized on the policies that curb disease occurrence. The main strategy was to create awareness to the public about diabetes mellitus and its complications through community programs, media houses, and posters. Mass education is the first preventive measure since the individuals take their personal initiative to prevent disease occurrence. The care providers did a diabetes mass screening for the population to find out the new cases of diabetes or the existing undiagnosed cases. The diagnosed patients were given follow-up clinics where the primary care physicians screened for diabetic leg ulcers. Patients at risk of developing diabetic leg ulcers were educated on the need for foot care and controlling glycemic levels. Patients with diabetic leg ulcers were pot on effective treatment care according to the grade of the ulcers. Diabetic Foot Ulcers Among Diabetic Patients essay

Grade one diabetic foot ulcer is a superficial lesion with partial or full-thickness. It is treated by optimum glycemic control, proper foot care, and antibiotics. Grade two leg ulcers extend to the ligaments, tendons, and deep fascia without abscess and osteomyelitis. It is managed by proper foot care, aseptic wound cleaning and dressing, antibiotics, and glycemic control. Grade three diabetic leg ulcer is characterized by an abscess or osteomyelitis that needs incision and drainage, intravenous antibiotics, and strict glycemic control. Grade four is characterized by gangrene of the foot that needs debridement (Rayman, et al, 2020). Of note is the complication associated with wound cleaning and dressing. According to Armstrong, et al, (2017), an ideal diabetic foot ulcer wound cleaning and dressing should allow gaseous exchange from the wound, protects from bacterial exposure, should absorb the would exudate without drying the wound and reduce pain and itchiness. Diabetic Foot Ulcers Among Diabetic Patients essay

Comparison

During the cross-section study, diabetic patients at risk of developing diabetic leg ulcers were divided into two groups, group A and group B. The criterion for selecting the participants was any diabetic patient above 30 years old. Group A patients were under strict glycemic control, follow-up clinics, educated on the risk factors of diabetes mellitus, signs of leg ulcers, and proper foot care. Group B was not put only on oral anti-diabetics (Mariam, et al, 2017). They were neither educated on foot care practices nor other complications of diabetes. These groups were observed for one year. Diabetic Foot Ulcers Among Diabetic Patients essay

Outcome

Group A. patients were reviewed after one year of proper glycemic control, proper foot care, and patient education, and regular monitoring of the patient’s vitals to assess the risk of diabetic foot ulcer. 94% of the patient turned out with controlled glycemic levels and did not have diabetic leg ulcers. 6% of the patients had grade one leg ulcers which developed due to non-compliance to medication and foot care. Group B. patients were reviewed after one year of anti-diabetic treatment. 10% of the patients had well-controlled glycemic levels and no leg ulcers while 90% had poorly controlled glycemic levels and chronic diabetic leg ulcers that resulted from septic wound cleaning and dressing technique (Mariam, et al, 2017).

From the study, the prevalence of diabetic foot ulcers is due to a lack of awareness of diabetes mellitus and its complication, lack of effective foot care practices, and non-compliance to diabetic medications. The complication of the leg ulcers was due to septic dressing techniques by the nurses and septic debridement, incision, and drainage procedures by the attending doctors. Other factors that contributed to the complication of foot ulcers are other comorbidities such as vascular diseases and anemia (Rayman, et al, 2020). The patient’s social factors are smoking tobacco, drinking alcohol, and physical inactivity. Diabetic Foot Ulcers Among Diabetic Patients essay

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In this course, you will be complete a 2-part assignment in which you conduct research about a population of focus, develop a PICOT statement, and write a Literature Review. The PICOT statement and Literature Review you write in this course can be used for your evidence-based practice project in the next course so be sure to select an issue you want to continue working on in your next course. PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting the population of focus. Additionally, the information derived from a good PICOT makes it easier to perform a literature search in order to find translational research sources that can be used to address the clinical problem. Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Diabetic Foot Ulcers Among Diabetic Patients essay

Use this indicator to begin to formulate a PICOT and conduct research on the population. Write a 750-1,000-word paper that analyzes your research and focuses on the population you have chosen. Describe the population’s demographics and health concerns, and explain how nursing science, health determinants, and epidemiologic, genomic, and genetic data may impact population health management for the selected population. Provide an overview of a potential solution for solving the health issue related to your population and the intended PICOT statement. Describe how the solution incorporates health policies and goals that support health care equity for the population of focus. You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Benchmark Information This benchmark assignment assesses the following programmatic competencies: MS Nursing: Public Health MS Nursing: Education MS Nursing: Acute Care Nurse Practitioner MS Nursing: Family Nurse Practitioner MS Nursing: Health Care Quality and Patient Safety 4.1: Synthesize nursing science, determinants of health, and epidemiologic, genomic, and genetic data in the management of population health. Diabetic Foot Ulcers Among Diabetic Patients essay

References

Armstrong, D. G., Boulton, A. J., & Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. New England Journal of Medicine376(24), 2367-2375.

Mariam, T. G., Alemayehu, A., Tesfaye, E., Mequannt, W., Temesgen, K., Yetwale, F., & Limenih, M. A. (2017). Prevalence of diabetic foot ulcer and associated factors among adult diabetic patients who attend the diabetic follow-up clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-based cross-sectional studyJournal of diabetes research2017.

Rayman, G., Vas, P., Dhatariya, K., Driver, V., Hartemann, A., Londahl, M., … & International Working Group on the Diabetic Foot (IWGDF). (2020). Guidelines on the use of interventions to enhance the healing of chronic foot ulcers in diabetes (IWGDF 2019 update). Diabetes/Metabolism Research and Reviews36, e3283.

Tilg, H., Moschen, A. R., & Roden, M. (2017). NAFLD and diabetes mellitus. Nature reviews Gastroenterology & hepatology14(1), 32-42. Diabetic Foot Ulcers Among Diabetic Patients essay

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