The project focuses on providing education programs for both the indigenous individuals with diabetes and both health workers. Generally, it dwells education on the foot complication for those individuals who are suffering from diabetes, with the application of a screening tool for getting to know individuals at high risk and education incentives to ensure self-care. We used data from the population-based Mid North coast Diabetes Registry which has the number and details of all people receiving care in Mid North coast health system (Rasmussen, Yderstraede, Carstensen, Skov, & Beck-Nielsen, 2015). The research is to use the post and pre-evaluation design method, with workshop participant invented to make completion of pre-knowledge questionnaires and a follow-up questionnaire that were sent out after the completion of action which went along with an evaluation survey. The data which was obtained was analyzed by the use of descriptive statistics. Basically, the overall result found the confidence level and the knowledge base improved after the workshop. The research concluded that, with the increase diabetes prevalence, in Mid North Coast indigenous people, our result showed that even in rural and remote areas, mortality and complication can be reduced (Cheng et al., 2016)
Diabetes mellitus have made a negative impact, living a great mark in the society. Statistically, it has been proven that the prevalence of diabetes mellitus is four times more than all cancers brought together. Due to the constant increase of life expectancies, diabetes mellitus have lead to nine percent global mortality. Some of the diabetes complication includes multifactorial pathogenesis together with the neuropathy, repeated trauma a very serious foot infection (Carrington et al., 2001). In Mid North Coast the infected, are Longley admitted to hospitals which in the long run contributes to 90% of lower limb amputation. The increasing rise of diabetes has impacted the society negatively through a significant burden because of an increase in diabetic amputations. In reference to Biddle,(et al., 2014) Despite the action taken to create awareness on early prevention, management, and detections, the whole process has not perfectly worked as a result of management noncompliance and inconsistent patient follow-up. Generally, existing studies have proven that identified the presence of macros vascular complications and indigenous ethnicity as contributing factors to amputation (Lewis, Bucher, & Dirksen, 2014). No current data is existing on the burden of macro vascular outcomes or amputation on those who are affected by diabetes mellitus in mid-North coast which is home to the indigenous population which is at higher risk of diabetes. This study is purposefully aiming to bridge the gap that is existing between the current knowledge gaps, with a specific focus on reducing the number of foot amputation in indigenous population due to diabetes mellitus in Mid North Coast.
1. To Provide an education model for Mid East Coast Health Workers to implement in the community.
2. To reduce the number of hospital admissions for foot complications in the Mid East Coast.
3. To reduce the number of diabetic foot complications such as ulceration and lower limb amputations in the Mid East Coast.
4. To Increase the skill base of Mid East Cost health Workers.
5. To increase the number of Mid East Cost people being screened for diabetic foot risk factors.
1. Being able to provide education for health workers about the complications of diabetes within the foot,
2. Focusing on providing a screening tool for assessing the diabetic foot,
3. To Provide culturally appropriate resources, to those affected by diabetes.
4. Provide advice on referral pathways if further intervention is needed.
5. To include an education model which enables the health workers to teach and empower patients to self-care.
Project key personnel
Technically for the research to completely achieve its major and specific objectives, it had to involve different individuals and participants. In reference to the participants, the entire participant volunteered to be a part and parcel of the program. Basically, the majority of the participant came from health workers that were (Mid North Coast Health Education Officers, different level of Nurses, Allied Health staffs) who were in the work nature interacting with the Mid North Coast individuals (Pendsey, 2013). Notable, the participant who were recruited to attend the education program that we were able to offer, were actually informed through communicating by giving out general flyers to health sections and sites that was within the Lower Mid North Coast (Comment on Hoffstad et al. Diabetes, Lower-Extremity Amputation, and Death. Diabetes Care 2015;38:18521857 | Diabetes Care, n.d.). The communication process that was used when contacting service managers was basically through using email that included all the program details , this was then forwarded to their staff to ensure effectively and communication flow.
Key project stakeholders
Focusing on ethics, the technical ethical permit and approval will be provided by the Hunter New England Human Research Ethics Committee, this approval will actually take place in the year two thousand and seventeen the month of June. The permit and ethical approval are supposed to be provided and granted by the Mid North Coast Health & Medical Research Council which will take place in October the year two thousand and seventeen (Manderson, Cartwright, & Hardon, 2016)
Notably, the key personnel that will be involved when it comes to funding the whole project is an agreement deal that will involve and obtain the funding process through the Rural Capacity Research Building Program. This program is jointly operated by the Clinical Education and Training Institute (CETI) (The care of trans metatarsal amputation in diabetic foot gangrene - Amendola - 2016 - International Wound Journal - Wiley Online Library, n.d.).In handling the whole project and dealing with different personnel to achieve the objectivity of the project, no conflict of interest is at all projected.
In the project design, pre-workshop knowledge questionnaire will be provided to participants, this will be actually a repeated action to ensure sustainability when it comes to the conclusion of the workshop. For effectively and efficiency, a follow-up knowledge questionnaire is also sent out six months after the workshop which is sent with an evaluation survey in the same process. Since the research will focus on small sample size the descriptive statistics were used to have a presentation of data to be obtained.
Focusing on project sustainability the project focuses on capitalizing on the increased confidence and different new skills achieved by the individual participants in the training support that is actually handled from skilled health professionals such as the needed podiatrists to help manage the whole situation (Rodrigues, Vangaveti, & Malabu, 2016). For project sustainability one of the strategies to be implemented is the collaborative approach, the collaborative approach will facilitate increased uptake of screening, improve and create enhancement when it comes to preventative care with great advantages for clients and health workers as well. Objectively success will be achieved since it will help in early identification of people at high risk of developing foot problems and the most convenient and appropriate models of education which are actually the key when it comes to making a reduction in the number of various challenging foot complications (Solomon et al., 2008).
Notably, in ensuring sustainability, project knowledge based questionnaire will be generated; this will help in performing the pilot test. By performing a pilot test, efficiency is actually ensured, since it provides an overview of what will happen in the data collection process. The questionnaires will also incorporate questions that entail the level of confidence from participants with certain aspects of diabetic foot assessments (Axonopathy in peripheral neuropathies: Mechanisms and therapeutic approaches for regeneration, n.d.).
Project strategies verse Activities table
Strategies Key activities Time frame for each activity Positions involved Responsible person
Being able to provide education for health workers about the complications of diabetes within the foot. Creating awareness to those affected and the general indigenous Mid North coast on the meeting dates and the venue for where training is to be held.
Group or individual patient education is arranged.
Organize print out which are educative through making sure that information pertaining to complication of diabetes within the foot, the prevention and actually managing life after amputation.
Offering education and imparting knowledge through knowledge to the health workers on the complication of diabetes and what patients should do and how the diabetes patient should be handled to ensure prevent complication of diabetes among the foot (Hunter et al., n.d.).
Practicing practical skills after training before releasing the trained health workers to officially go and handle patients and even test them. 1 week
4 days Health education officers,
Indigenous clients and
clinical health workers and diabetes educators
Specialist podiatrist/ foot protection team 50%Trained clinical officers, 20%diabetes educators 30%nurses and health workers.
Focusing on providing a screening tool for assessing the diabetic foot Patients feet are checked for other inflammatory conditions such as Charcot Neuroarthropathy, fracture, dislocation, critical limb ischemia.
Immediate assessment of the foot (within 4 hours) is undertaken by a member of the admitting medical / nursing team.
The patients perception of their problem is identified and their related perceived needs: Current beliefs, effects on life, and barriers to acting on standard advice.
A full surgical history is taken: such as vascular, orthopedics, amputation. Routine
5days Specialist podiatrist/ foot protection team To Provide culturally appropriate resources, to those affected with diabetes. Patients are told what services to expect regarding foot care.
Patients are basically sensitized and educated on how to manage symptoms (for example persistent pain and bad odour).
Patients are educated and provided by necessary medicine and advice, the potential consequences of neglecting their feet.
Patients are given details of where and when to seek advice. 1-3 weeks
2hrs Diabetologist, Nurses and clinical officers. Provide advice on referral pathways if further intervention is needed Patient has emergency access to a Foot Protection Team including self-referral within one working day.
Patient are assessed and referred for other lifestyle changes including smoking, alcohol intake, exercise, weight loss as required.
Patients are referred for assessment and appropriate treatment of neuropathic pain including optimizing glycaemic control and neuropathic analgesics.
Patients receive regular Podiatry treatment by a Foot Protection Team. Frequency of provision of skin and nail care is dictated according to need.
Routine Diabetic educator, nurses and clinical officers
To include an education model which enables the health workers to teach and empower patients to self care Where extensive tissue death of digits has occurred (local gangrene) dressings must...
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