Authors (including presenting author) :
Yung CK(1), Tsui KN(1), Mak KM(1), Wong N(1), Mok SS(1), Tsoi YK(1)
Affiliation :
(1)Department of Medicine, Haven of Hope Hospital
Introduction :
Peripheral vascular disease (PVD) is a significant health concern that often leads to severe complications, including foot ulcers. These ulcers not only increase morbidity but also contribute to patient suffering, higher rates of amputation and prolonged hospitalization. The importance of preventive measures cannot be overstated, especially in high-risk populations. This essay discusses the role of nursing in implementing a foot ulcer prevention program at Haven of Hope Hospital, focusing on screening for high-risk PVD cases and providing essential nursing interventions.
Objectives :
1) To establish an early detection workflow for PVD 2) To promote preventive care practices for foot ulcer
Methodology :
Nursing staff conducted risk assessments upon patient admission to identify those at high risk for peripheral vascular disease (PVD), focusing on factors like diabetes, cardiovascular risk factors and previous foot ulcers. This early screening facilitated timely referrals to podiatry services, promoting specialized care and reducing ulcer risk. To maintain warmth and moisture, nurses regularly checked limb temperatures and applied emollients to prevent skin cracks. They also implemented pressure reduction strategies, repositioning patients, and using specialized cushions to alleviate localized pressure. Daily inspections of lower limbs were performed, with nurses educating patients and families on self-assessment techniques for early detection of skin breakdown. Patient education emphasized proper foot care, suitable footwear, and hygiene practices, with demonstrations provided and informational pamphlets distributed upon discharge. This comprehensive approach aimed to enhance patient outcomes and minimize complications related to foot health.
Result & Outcome :
During the screening period from June to July, 2024, one hundred male patients were assessed upon admission. Out of these, 79 patients met the referral criteria for podiatric screening. Notably, 40 patients were suspected of having peripheral vascular disease (PVD) based on the results of the Ankle-Brachial Pressure Index (ABPI) and Toe-Brachial Pressure Index (TBPI) assessments, representing 50.6% of the total screened. Nursing interventions and patient education were provided to those 79 patients upon admission. Remarkably, only one case developed a foot ulcer during the hospital stay. This 1.3% of foot ulcer rate signifies a substantial reduction compared to global prevalence rates of hospital-acquired foot ulcers, which typically up to 15% in similar populations.
