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In the diabetes care wing of the hospital’s Primary Care Trust, significant lapses in the basic management of wounds for diabetic patients have been on the increase. Consequently, the patients have ended up being amputated on various parts of the body such as the legs and the toe. The people affected are the doctors, patients as well as care takers of the patients. This problem has been linked to various causes; chief among them is the failure by the patients to maintain normoglycaemia as hyperglycaemia has always been associated with impaired wound healing the patients are suffering from. The second cause is found to be the failure by the patients to frequently visit the hospital for nutritional assessment in order to determine the type 2 diabetes linked to obesity. Also, the failure by some doctors in the department to give providence to Diabetic peripheral neuropathy which scientifically affects both the sensory, motor and autonomic functions of diabetic patients has been found to be a cause. There the doctors either have deliberately ignored or neglected their duty to acknowledge and inform the patients that sensory neuropathy is one of the largely feared causes of diabetic foot ulceration. Therefore, the set goal is to ensure that improved wound care for diabetic patients is achieved as this will minimize their risk of being amputated.
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Needs Assessment
The actual purpose of the needs assessment is to constructively and systematically discern the nature and magnitude of the problem of wound care lapses among the diabetic patients in the hospital. Again, it is worthwhile to look into whether the problem has got significant correlation to family backgrounds of patients in areas such as education standards, levels of income. This is because; caring for the wounds of the diabetic patients is a multifaceted phenomenon that goes deep up to family conditions. Having known the magnitude of the problem, needs assessment will then take the following format. First of all, the doctors who treat these patients will undergo interviewing sessions as it is them who diagnose and treat these patients continuously. The family members of the patients who act as primary care givers will also be interviewed to provide information pertaining to their home conditions. In the last segment of the interviewing will be the patients themselves who understand their situation and may provide other causes to the problem not known to other stakeholders. Next, the doctors and the patients together with their family members will be asked on what they think are the possible solutions to the current situation facing the diabetic patients.
Once the needs assessment is done to completion and relevant information gathered, what proceed would be to make critical decisions on the following issues:
1- How to make the doctors more accurate and dutiful while handling diabetic patients?
2- Whether to provide refresher training for the doctors on the changing wounding care knowledge?
3- How much money would be required to conduct such training?
4- How to improve the level of awareness among diabetic patients and their families on the basic care methods for wounds?
5- Whether to involve the government and other stakeholders to support wound care initiative among the patients?
Goal Analysis
1. Goal Statement: After the training of the doctors on the changing situations of caring for diabetic wounds, and level of awareness among the patients and family members raised concerning the same, then increasing levels of ulceration and amputation of the patients will significantly drop. Meaning, the patients’ health levels will increase.
2. Description of Goal Statement
- Proper and appropriate documentation as well as assessment of the patients by the doctors.
- Proper and safe cleaning and/or debridement of the wounds by the doctors and the patients while way from the hospital.
- Effective establishment of a clean and moist wound bed for patients in the hospital as well as when they are at home.
- Effective management of wound fluids at all times, in the hospital or at home.