new horizons in diabetes foot care in nigeria october 21 st 2015 afokoghene rita isiavwe face...
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NEW HORIZONS IN DIABETES FOOT CARE IN NIGERIA
October 21st 2015
Afokoghene Rita ISIAVWE FACE
Medical Director & Consultant EndocrinologistRainbow Specialist Medical Centre
Lekki Phase 108030940649
www.rainbowspecialistMED.com
Outline
• Understanding the diabetes foot problem• The Diabetes Podiatry Initiative, Nigeria• Offloading• Wound Care• Summary• Acknowledgements
Understanding the Diabetes foot problem
Understanding the Diabetes foot problem
• Pivotal event • Marker of serious disease and co morbidities • May lead to amputation of the affected limb• Every 20 seconds a lower limb is amputated
due to complications of diabetes
St Vincent's Declaration
• A set of goals for the health care of persons with DM.
• Aim of improving diabetes care• The main target set for feet was to "reduce
the numbers of limb amputations for diabetic gangrene by 50% in a five year period" Preventing foot complications in diabetes
ACTION PLANS
Regular, systematic screening of feet and legsImmediate access to qualified foot care for
those at high risk. Systematic patient education in foot care. Establishment of multidisciplinary teams to
provide care for those with special needs.
What's New in Diabetes Foot Care in Nigeria
The Diabetes Podiatry Initiative Nigeria
DIABETES PODIATRY INITIATIVE NIGERIA
Supported by World Diabetes Foundation
Rainbow Specialist Medical CentrePodiatry Institute USA
2014 to 2017
A COLLABORATION
PODIATRY INSTITUTE USA• Rahn A. Ravenell, DPM –
USA Team Leader
RAINBOW SPECIALIST MEDICAL CENTRE
• Afokoghene R. Isiavwe FACE- Project coordinator
The World Diabetes Foundation
Objectives
• Building local capacity in diabetes foot care• Improving foot care in persons living with DM• Preventing diabetes related foot amputations
Target Audience
• Health Care Practitioners• Persons living with diabetes• Diabetes Peer educators• members of Diabetes Association of Nigeria
Selected Clinics and Hospitals
• General Hospital Marina• 2 Lagos State PHCs – Eti-osa & Ibeju Lekki• NNPC Medicals • Military Hospital• St Nicholas Hospital• Rainbow Specialist Medical Centre• St Kizito• Nigerian Ports Authority Clinic• Lagos University Teaching Hospital• National Orthopedic Hospital Igbobi
• Training of trainers • Patient Foot care Education
Approach
1. Initial monthly one day - 2 hour training ( 2CME Points)2. Providing foot care SCREENING kits to each trained
institution3. Annual 5 day DM foot care workshop by members of the
Podiatry Institute USA (10 CME points) – next in August 2016
4. Continuous monitoring and supervision of the selected institutions
5. Referring at risk patients for free foot care training6. follow up of patients with ulcer to heal or to amputation
1ST LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – MARCH 2014
1ST LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – MARCH 2014
1ST LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – MARCH 2014
2ND LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – AUGUST 2015
2ND LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – AUGUST 2015
2ND LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – AUGUST 2015
IMPACT SO FAR
• Regular foot screening at participating centers FOOT SCREENING MANUALS produced & distributed to
healthcare professionals nationwide; simple enough for nurses to administer.
Diabetes foot Care TRAINING MANUAL FOR HEALTHCARE PROFESSIONALS produced & distributed
FOOT SCREENING BAGS distributed to 11 participating hospitals in Lagos
Start up of foot care clinics at some of the different participating institutions
Patient foot care education charts and booklets distributed to participating centers and Lagos State DAN.
IMPACT SO FAR 2
• Establishment of multidisciplinary teams.Work in progress: participants in the last two
meetings have seen the need for synergy amongst the different stakeholders in the care of DMFS at the various participating institutions.
IMPACT SO FAR 3
Issues are being raised & successfully
addressed e.g. need for training of nurses on the art of
wound care ‘’wound care nurses’’ use of modern & effective wound care
products Offloading of ulcers
Offloading shoes and insoles
• Therapeutic shoes• Insoles • wound care shoes • locally available and
affordable
Wound care
• New and effective wound care products now locally available
summary
Conclusion
THANK
YOU
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