Diabetes/foot ulcers/knowledge translation Nutritional, Metabolic, Endocrine Unspecified diabetes mellitus
Conditions
Interventions
In addition to ?usual? implementation strategy, a 12 week strategy will be offered to mangers, supervisors, resource nurses, and two preceptor staff from each centre consisting of:
1. Mailed package
summary of recommendations, models of leadership and planned change
literature article
four questions related to assessing barriers to practice change. Review time: approx 15 - 30 minutes.
2. Interactive workshop (7.5 hours) at SEHC Corporate Office. Content and structure will be tail
SEHC senior administrator (NL)
and administrative/clinical staff from SEHC to be determined.
3. Post-workshop teleconferences: (2, 6, and 10 weeks after workshop) to provide a forum for questions, discussions and networking among
Sponsors
Canadian Nurses Foundation (Canada) - Nursing Care Partnership Fund
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Service delivery centres with minimum number of clients with diabetes being treated for foot ulcers to satisfy sample size calculations 2. Chart audit: all adult clients (18 years or older) diagnosed with type 1 or type 2 diabetes that have been treated for a first or recurring foot ulcer(s) in the previous 6 months 3. Intervention: managers, supervisors, resource nurses and two staff nurses from each intervention site
Exclusion criteria
Exclusion criteria: 1. Service delivery centres that did not have the minimum number of clients on service for diabetic foot ulcers to meet sample size calculations (i.e. 15 clients per centre in 6 months) 2. Clients that do not meet inclusion criteria: 2.1. Under 18 years of age 2.2. Do not have type 1 or type 2 diabetes 2.3. Not receiving home care service for a diabetic foot ulcer
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Nursing Assessments of Client Risk Factors Scores (NACRF), a composite score of 8 items based on recommendations from the Diabetes/Foot Ulcer guidelines. Timepoints for primary and secondary outcomes: 12 weeks following completion of the intervention, chart audits will be conducted on all patients being treated for diabetic foot ulcers. To understand the leadership and management behaviours that influenced nursing practice, semi structured qualitative interviews will be conducted 12 weeks following intervention strategy with managers, supervisors, resource nurses and staff nurses at control and experimental centres. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Proportion of people with healed ulcers at 12 weeks (defined as complete wound closure) 2. Healing time, in number of weeks 3. Types of treatments used (e.g., hydrogel dressings, sharp debridement, offloading devices) 4. Referral rates to specialists services 5. Documented patient education 6. Proportion clients assessed for all items in the NACRF scale (all-or-none measure) 7. Nursing participant satisfaction and perceived utility of elements of the intervention Timepoints for primary and secondary outcomes: 12 weeks following completion of the intervention, chart audits will be conducted on all patients being treated for diabetic foot ulcers. To understand the leadership and management behaviours that influenced nursing practice, semi structured qualitative interviews will be conducted 12 weeks following intervention strategy with managers, supervisors, resource nurses and staff nurses at control and experimental centres. | — |
Countries
Canada
Outcome results
None listed