Step up care for diabetic foot.
Nurses are integral to helping patients preventa common diabetes complication that threatens life and limb.
Biomedical subjects
Publications and source records attributed to Mary Y Sieggreen.
Nurses are integral to helping patients preventa common diabetes complication that threatens life and limb.
Explore the source record for details and available documents.
The Detroit Medical Center nursing documentation system requires all staff nurses to complete the Braden Scale for Predicting Pressure Sore Risk on an Acute Care Flow Record or Critical Care Flow Sheet on every patient, every day. An audit of these records raised concern as to whether staff nurses accurately used the Braden Scale to calculate pressure sore risk. Advanced Practice and ET Nurses noted that staff nurses were rating patients at lower levels of pressure sore risk than was warranted by the patient condition. In response, a computer-based learning module with case study examples was developed and tested to teach nursing staff to accurately evaluate pressure ulcer risk by using the Braden Scale and its subscales and to identify preventive interventions based on the patient's Braden subscale scores. Following revisions of those case study example narratives that were found to be problematic, the learning/assessment module was instituted in 2002. More than 2,500 nurses at the facility were tested regarding their knowledge of pressure ulcer risk assessment and prevention using this program. On average, nurses correctly rated the Braden Scale level of risk 75.6% of the time. The percentage of correct responses was highest for very high (92%) and very low (78%) levels of risk. This finding is consistent with the observation that most nosocomial pressure ulcers in this facility occur in patients who are rated in the "mild risk" level on the Braden scale. Subscales with the lowest percentage of correct answers were moisture and sensory perception. Correct clinical identification of a Stage I pressure ulcer as it was described in writing occurred only 53% of the time. These results indicate that training and practice are needed to use an assessment scale accurately. The Detroit Medical Center plans to include the Braden Scale in annual nursing education and competency testing.
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PURPOSE: To provide physicians and nurses with an overview of the pathophysiology, assessment and diagnosis, and treatment of lymphedema. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in managing patients with lymphedema. OBJECTIVES: After reading the article and taking the test, the participant will be able to: 1. Describe the pathophysiology of lymphedema and the difference between transient and chronic lymphedema. 2. Describe the assessment and diagnosis of lymphedema. 3. Identify treatment options and teaching considerations for patients with lymphedema.
PURPOSE: To provide physicians and nurses with an overview of the pathophysiology, assessment, diagnosis, and treatment of arterial insufficiency and ulceration. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in managing patients with arterial insufficiency and ulceration. OBJECTIVES: After reading the article and taking the test, the participant will be able to: 1. Describe the anatomy and physiology of the lower extremity arterial system and the pathophysiology of arterial ulcers. 2. Describe the assessment and diagnosis of arterial insufficiency and ulceration. 3. Identify treatment options and teaching considerations for patients with arterial insufficiency and ulceration.
PURPOSE: To provide physicians and nurses with an overview of the pathophysiology, assessment, diagnosis, and treatment of venous insufficiency and ulceration. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in managing patients with venous insufficiency and ulceration. OBJECTIVES: After reading the article and taking the test, the participant will be able to: describe the anatomy, physiology, and pathophysiology of the lower extremity venous system; describe the assessment and diagnosis of venous insufficiency and ulceration; identify treatment options and teaching considerations for patients with venous insufficiency and ulceration.