Clinical audit reveals drop in diabetes associated foot ulcer cases

Camille Bienvenu
Tue, 28 Jun 2016
Clinical audit reveals drop in diabetes associated foot ulcer cases
The National Diabetes Inpatient Audit (NaDIA) group has released today the results of an investigation it has conducted last year on foot ulcers acquired during hospital visits.

Results from the 2015 survey indicate that cases of the diabetes related complication have decreased by 50 per cent and equates to an estimated annual saving of over £30 million.

The audit, performed in collaboration with Diabetes UK, revealed that 1.1 per cent of patients presenting the condition had foot lesions compared to the 2.2 per cent found in 2010.

Although positive overall, the report also discovered that patients didn't receive certain standard procedures in a timely manner and that the rising number of diabetes patients is not matched by appropriate resources and staffing.

The audit team, led by clinician Dr Gerry Rayman, investigated whether patients received what is called low-value care, which they measured by looking at particular tests and procedures patients had undergone in a year.

The operation, carried out by diabetes specialists in 135 trusts and six Local Health Boards throughout England and Wales, assessed staffing levels, medication errors, patient harms and patient experience of 15,299 patients with diabetes.

The inpatient diabetes team found that more than two thirds (67 per cent) of these patients did not undergo diabetic foot risk examinations.

A significant number (31 per cent) of hospital sites surveyed did not facilitate multi-disciplinary diabetic foot care, despite previous audits stressing its necessity.

Data from the audit showed that the number of people with diabetes in hospital beds has increased from 14.6 per cent in 2010 to 16.8 per cent in 2015, but staffing numbers stayed the same. Almost one-third of sites visited did not have a diabetes specialist nurse either.

In addition, there have been no more improvements in hypoglycemic episodes and diabetic ketoacidosis, which the report suggests could be down to medications errors. A good proportion of patients (23.9 per cent) experienced at least one medication management error within the week prior to the survey.

Since 2010, evaluations done by NaDIA have been a useful tool for highlighting specific issues in patient care, improve patient experiences and save money for hospital trusts.

The publication of individual results for complication rates from particular kinds of procedures, as well as rankings of how well the medical community is doing also encourages transparency, which inform patients and health professionals of what really great places are doing and what they could do differently.
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