As nursing leaders we must empower our staff to improve the quality and safety of patient care. The
Management and Leadership track of the American Sentinel MSN program has guided me towards cultivating future nurse leaders to prepare them to create a sense of ownership and commitment to their work and the organization as a whole. The evidenced based practice project proposed to be implemented at the Veterans Administration Medical Center (VAMC) will cultivate the staff to improve the quality of care for the veteran population. The proposed practice change project focuses on improving diabetic foot related problems in the End Stage Renal Disease population receiving hemodialysis/peritoneal dialysis.End Stage Renal Disease is a slow progressive …show more content…
The unit has eleven stations with a patient population of 40, with an age range from forty to ninety two. Most of the hemodialysis patients have difficulty managing their chronic illness whereby they must attend treatment three times a week for a period of 5 hours per visit. Most of them have multiple morbidities. More than sixty percent of the population is diabetic and sixteen percent of the remaining population has peripheral vascular disease. According to the literature the prevalence of peripheral vascular disease (PVD) is greater in this population (Crozier, 2014). It was evident there was a lack of education about foot care among this veteran population and the need to create a program to educate and screen for possible foot related issues due to the risk factors involved. The proposed plan includes a multidisciplinary group of health care providers; the primary care physician, diabetic education, podiatry department including podiatrist, wound care nurse, wound care nurse, nephrologist and hemodialysis nurses. They are part of the proposed plan and dedicated to being available should the need arise for consulting purposes or
early …show more content…
non-diabetic population on hemodialysis. Sixty patients were asked to have a comprehensive foot check analysis. The hospital electronic medical record was used to identify the diabetic patients to ask. This was an observational study done in a satellite facility. A foot screening tool was used to identify risk factors associated with foot ulceration such as peripheral arterial disease, peripheral neuropathy, or foot pathology. Risk factors for ulcerations were recorded at baseline for all patients and mortality data was revisited after three years. Foot pathology was noted in 79%, 18% of non-diabetics had peripheral neuropathy, 45% of diabetics and 30% of non- diabetics had PAD. 49% of the of the total unit had greater than or equal to 2 of the 3 independent risk factors for foot ulcerations. Mortality independent of the patients age was predictive in those pts with PAD and PN. Findings showed a high prevalence of risk factors for foot ulcerations in the hemodialysis population, independent of their history of diabetes or PVD.
Proposal for Implementation This project will provide assessment, education and recommendations for continued
Management and Leadership track of the American Sentinel MSN program has guided me towards cultivating future nurse leaders to prepare them to create a sense of ownership and commitment to their work and the organization as a whole. The evidenced based practice project proposed to be implemented at the Veterans Administration Medical Center (VAMC) will cultivate the staff to improve the quality of care for the veteran population. The proposed practice change project focuses on improving diabetic foot related problems in the End Stage Renal Disease population receiving hemodialysis/peritoneal dialysis.End Stage Renal Disease is a slow progressive …show more content…
The unit has eleven stations with a patient population of 40, with an age range from forty to ninety two. Most of the hemodialysis patients have difficulty managing their chronic illness whereby they must attend treatment three times a week for a period of 5 hours per visit. Most of them have multiple morbidities. More than sixty percent of the population is diabetic and sixteen percent of the remaining population has peripheral vascular disease. According to the literature the prevalence of peripheral vascular disease (PVD) is greater in this population (Crozier, 2014). It was evident there was a lack of education about foot care among this veteran population and the need to create a program to educate and screen for possible foot related issues due to the risk factors involved. The proposed plan includes a multidisciplinary group of health care providers; the primary care physician, diabetic education, podiatry department including podiatrist, wound care nurse, wound care nurse, nephrologist and hemodialysis nurses. They are part of the proposed plan and dedicated to being available should the need arise for consulting purposes or
early …show more content…
non-diabetic population on hemodialysis. Sixty patients were asked to have a comprehensive foot check analysis. The hospital electronic medical record was used to identify the diabetic patients to ask. This was an observational study done in a satellite facility. A foot screening tool was used to identify risk factors associated with foot ulceration such as peripheral arterial disease, peripheral neuropathy, or foot pathology. Risk factors for ulcerations were recorded at baseline for all patients and mortality data was revisited after three years. Foot pathology was noted in 79%, 18% of non-diabetics had peripheral neuropathy, 45% of diabetics and 30% of non- diabetics had PAD. 49% of the of the total unit had greater than or equal to 2 of the 3 independent risk factors for foot ulcerations. Mortality independent of the patients age was predictive in those pts with PAD and PN. Findings showed a high prevalence of risk factors for foot ulcerations in the hemodialysis population, independent of their history of diabetes or PVD.
Proposal for Implementation This project will provide assessment, education and recommendations for continued