Allen Michelle L, Van der Does Albertine M B, Gunst Colette
Division of Family Medicine and Primary Care, Stellenbosch University and Swartland Hospital, Malmesbury.
Afr J Prim Health Care Fam Med. 2016 Aug 31;8(1):e1-9. doi: 10.4102/phcfm.v8i1.955.
Foot screening is an important part of diabetic care as it prevents significant morbidity, loss of function and mortality from diabetic foot complications. However, foot screening is often neglected.
This project was aimed at educating health care workers (HCWs) in a primary health care clinic to increase diabetic foot screening practices.
A primary health care clinic in the Western Cape province of South AfricaMethods: A quality improvement project was conducted. HCWs' needs were assessed using a questionnaire. This was followed by focus group discussions with the HCWs, which were recorded, transcribed and assessed using a general inductive approach. An intervention was designed based on common themes. Staff members were trained on foot screening and patient information pamphlets and screening tools were made available to all clinic staff. Thirty-two consecutive diabetic patient folders were audited to compare screening in 2013 with that in 2014 after initiation of the quality improvement cycle.
HCWs' confidence in conducting foot screening using the diabetic foot assessment questionnaire improved markedly after training. Diabetic foot screening practices increased from 9% in 2013 to 69% in 2014 after the first quality improvement cycle. A strengths, opportunities, aspirations and results (SOAR) analysis showed promise for continuing quality improvement cycles.
The findings showed a significant improvement in the number of diabetic patients screened. Using strategic planning with appreciative intent based on SOAR, proved to be motivational and can be used in the planning of the next cycle.
足部筛查是糖尿病护理的重要组成部分，因为它可预防糖尿病足并发症导致的严重发病、功能丧失和死亡。然而，足部筛查常常被忽视。
本项目旨在对一家初级保健诊所的医护人员进行教育，以增加糖尿病足部筛查的实践。
南非西开普省的一家初级保健诊所
开展了一项质量改进项目。使用问卷对医护人员的需求进行了评估。随后与医护人员进行了焦点小组讨论，讨论内容进行了记录、转录，并采用一般归纳法进行评估。根据共同主题设计了一项干预措施。对工作人员进行了足部筛查培训，并向所有诊所工作人员提供了患者信息手册和筛查工具。在质量改进周期开始后，对连续32份糖尿病患者病历进行了审核，以比较2013年和2014年的筛查情况。
培训后，医护人员使用糖尿病足部评估问卷进行足部筛查的信心显著提高。经过第一个质量改进周期后，糖尿病足部筛查实践从2013年的9%增加到2014年的69%。优势、机会、愿望和结果（SOAR）分析显示了持续质量改进周期的前景。
研究结果表明，接受筛查的糖尿病患者数量有显著增加。基于SOAR的带有欣赏意图的战略规划被证明具有激励作用，可用于下一个周期的规划。
