Standardising podiatric practice in diabetes foot ulceration management: outcomes from a regional quality improvement initiative

The standardisation of diabetic foot ulceration assessment and management is
important. A quality improvement initiative incorporating regional training for 227 podiatrists was completed in Northern Ireland to standardise the assessment and diagnosis of peripheral arterial disease and peripheral neuropathy. The SINBAD diabetic foot classification system and risk assessment were also included in podiatry practice. Response rates for pre- and post-training questionnaires were high at 85% (n=194) and 76% (n=173). The majority (99%, n=191) of respondents listed pulses, Doppler sounds and ABPI results as important in vascular assessment and 70% (n=108) stated they had learnt new information about Doppler sounds, ABPI technique (83%; n=108), clinical signs and symptoms (72%; n=125) and their differential diagnosis
(33%, n=51). The Edinburgh Claudication Questionnaire was new for 36.4% (n=63). The correct use of the Neurotip™ and neurothesiometer in neurological assessment was new for 56.6% (n=63) and 43.4% (n=75) attendees respectively. The interpretation of results was a key learning area for 81% (n=140). Respondents used the SINBAD classification system (65%; n=112) and a risk assessment tool (74%; n=128) in practice. This project has placed safety and the delivery of high-quality care to service users at the centre of podiatry practice in the region.