Posts

Health Quality Ontario’s Diabetic Foot Ulcers Quality Standard focuses on care for people who have developed or are at risk of developing a diabetic foot ulcer. The scope of the standard covers all settings, including primary care, home and community care, long-term care, and acute care. It also provides guidance on optimal care when a person transitions between these settings—for example, when someone is discharged from a hospital to their home or a long-term care home.

The quality standard includes 12 quality statements addressing areas that have high potential for improving the quality of care in Ontario for people with diabetic foot ulcers.

Below is a sample of tools that may help you with the implementation of the quality statements into practice, organized according to purpose. Several of these tools will help to support multiple quality statements.

Are there other tools or resources you use? Do you have experience implementing these tools? If you have feedback about any of these tools, please use the comments section below to share!

Risk Assessment:

• ABPI and TBPI Interpretations—a chart shared by the Waterloo Wellington Integrated Wound Care Program to interpret and record the Ankle Brachial Pressure Index (ABPI) and the Toe Brachial Pressure Index (TBPI)
• Inlow’s 60-second Diabetic Foot Screen—a tool shared by Diabetes Canada to help clinicians in the assessment and management of diabetic foot ulcers

Patient Education and Self-Management

• Address Patient-Centered Concerns—resources and information from the Waterloo Wellington Integrated Wound Care Program to help health care providers develop a patient-centered approach
• Foot Care: A Step Toward Good Health—a resource from Diabetes Canada with information about how diabetes can affect foot health and how to prevent wounds
• Healthy Feet—a program developed by Diabetic Foot Canada that offers patients and caregivers information and tools to promote foot health in people with diabetes
• My Diabetic Foot Ulcer Self-Care Wound Dressing Guide—a step-by-step guide from the South West Regional Wound Care Program to help patients and caregivers learn how to change a diabetic foot ulcer dressing

Referral to an Interprofessional Team | Comprehensive Assessment | Individualized Care Plan

The topics of “Referral to an Interprofessional Team,” “Comprehensive Assessment,” and “Individualized Care Plan” all share the same tools, which are listed together below:

• Criteria for Interdisciplinary Referrals—a tool by the South West Regional Wound Care Program to help determine if a referral for pressure injury is required
• Diabetes Foot Care Clinical Pathway—a health care provider’s guide developed by Alberta Health Services to enhance early detection and timely treatment of diabetes-related foot problems
• Diabetic Foot Ulcer Clinical Pathway—a tool developed by the Waterloo Wellington Integrated Wound Care Program to provide guidance on assessment, timelines, and expected outcomes
• Diabetic Foot Ulcer Risk Stratification and Referral Algorithm—a tool from St. Joseph’s Health Care London and the South West Regional Wound Care Program used to determine risk assessment, foot ulcer risk, and develop a follow-up plan
• Guideline: Assessment and Treatment of Diabetic and Neuropathic Ulcers in Adults—a guideline by a collaboration of wound care specialists and health agencies in Ontario that focuses on the assessment and determination of treatment goals and consequent interventions
• Fast-Track Pathway for Diabetic Foot Ulceration—a fast-track care pathway shared by the International Working Group’s Diabetic Foot website

Pressure Redistribution

• Guideline: Fiberglass Total Contact Casting, Removable Cast Walkers, and Irremovable Cast Walkers to Treat Diabetic Neuropathic Foot Ulcers—a guideline by a collaboration of wound care specialists and health agencies in Ontario on the types and use of devices to treat diabetic neuropathic foot ulcer
• Provider Pathway for Offloading Devices for Individuals with Diabetic Foot Ulcers—a tool from the South West Regional Wound Care Program to help manage patients with diabetic foot ulcers
• Offloading Plantar Pressure in Diabetes (scroll to #4 and click on “Product Picker Offloading”)—a resource from Wounds Canada to help users choose the most appropriate offloading device for patients with plantar diabetic foot ulcers

Health Care Provider Training and Education

• e-footcare—an online course designed with international experts to provide free access for professionals who take care of persons living with diabetes in order to reduce diabetic foot complications leading to amputations

Comprehensive Tools and Resources for the Diabetic Foot Ulcer Quality Standard

The following tools and/or resources may apply to more than one topic in the Diabetic Foot Ulcer Quality Standard.

• Assessment and Management of Foot Ulcers for People with Diabetes—clinical best practice guidelines (2nd edition) by the Registered Nurses’ Association of Ontario
• Diabetic Foot Ulcers Prevention and Management Recommendations—a guide developed by the Waterloo Wellington Integrated Wound Care Program to prevent and manage diabetic foot ulcers

Comment below to describe your experience with these tools or share any others you have found useful!