CPD practice profile
SCIenCe PHoTo lIbRARy
Autonomic neuropathy is caused by damage to the parasympathetic and sympathetic nerves, and it affects various body structures and processes such as the cardiovascular system. Charcot neuropathy causes bone destruction and can lead to severe deformity of the foot, decreased mobility and ulceration.
Areas of testing
Diabetic neuropathy Reading a CPD article helped Sue Francis to realise the importance of performing annual foot assessments Being a practice nurse I often meet patients with diabetes who are at risk of developing diabetic neuropathy, a common complication that damages the nerves. Reading the CPD enhanced my practice as it highlighted the importance of annual foot assessments, and helped me to identify early signs of damage that could lead to foot ulceration, amputation, poor quality of health and increased mortality. It is vital that patients, carers and healthcare staff understand that even minor foot trauma may have devastating consequences. About half of patients with type 2 diabetes have at least one complication at the time of diagnosis, of which neuropathy is the most common long-term example. The first year following diagnosis is a critical time for the development of foot ulcers, which have a high risk of infection
and could lead to amputation. The four different types of neuropathy were explained in the article – motor, sensory, autonomic and Charcot. Motor neuropathy affects the nerve supply of the muscles of the foot, and causes deformity that leads to abnormal pressure points and ulceration. Sensory neuropathy causes sensations such as pain, and changes in feeling and temperature, and can lead to ulceration because the person may not be aware that damage is occurring.
This practice profile is based on NS683 Holt P (2013) Assessment and management of patients with diabetic foot ulcers. Nursing Standard. 27, 27, 49-55.
Having read the article I will ensure that patients with diabetes have annual foot assessments. During assessment it is important to remove hosiery so the feet can be inspected, and to ask questions about problems relating to pain, dry skin, ill-fitting footwear and callus formation on the soles of feet. I am now more aware of how to carry out an effective foot assessment using monofilament testing on five areas and performing palpation of foot pulses. Any ulcer formation, particularly with infection, needs immediate attention and I will refer patients with foot ulceration to the multidisciplinary foot care team immediately. Reading this article has made me reflect on how to alter my practice to enhance care giving. I intend to study diabetes further, and perform thorough foot care assessment as part of the healthcare review of a patient with diabetes, ensuring that I follow recent guidelines and acknowledge my limitations NS Sue Francis is a practice nurse at Grange Medical Centre, West Yorkshire
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 50 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
NURSING october :: vol 28without no 9 :: permission. 2013 61 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 24, 2015. For personal use only. No30 other uses Copyright © 2015 RCNi Ltd. All rights reserved.
SCIenCe PHoTo lIbRARy
Autonomic neuropathy is caused by damage to the parasympathetic and sympathetic nerves, and it affects various body structures and processes such as the cardiovascular system. Charcot neuropathy causes bone destruction and can lead to severe deformity of the foot, decreased mobility and ulceration.
Areas of testing
Diabetic neuropathy Reading a CPD article helped Sue Francis to realise the importance of performing annual foot assessments Being a practice nurse I often meet patients with diabetes who are at risk of developing diabetic neuropathy, a common complication that damages the nerves. Reading the CPD enhanced my practice as it highlighted the importance of annual foot assessments, and helped me to identify early signs of damage that could lead to foot ulceration, amputation, poor quality of health and increased mortality. It is vital that patients, carers and healthcare staff understand that even minor foot trauma may have devastating consequences. About half of patients with type 2 diabetes have at least one complication at the time of diagnosis, of which neuropathy is the most common long-term example. The first year following diagnosis is a critical time for the development of foot ulcers, which have a high risk of infection
and could lead to amputation. The four different types of neuropathy were explained in the article – motor, sensory, autonomic and Charcot. Motor neuropathy affects the nerve supply of the muscles of the foot, and causes deformity that leads to abnormal pressure points and ulceration. Sensory neuropathy causes sensations such as pain, and changes in feeling and temperature, and can lead to ulceration because the person may not be aware that damage is occurring.
This practice profile is based on NS683 Holt P (2013) Assessment and management of patients with diabetic foot ulcers. Nursing Standard. 27, 27, 49-55.
Having read the article I will ensure that patients with diabetes have annual foot assessments. During assessment it is important to remove hosiery so the feet can be inspected, and to ask questions about problems relating to pain, dry skin, ill-fitting footwear and callus formation on the soles of feet. I am now more aware of how to carry out an effective foot assessment using monofilament testing on five areas and performing palpation of foot pulses. Any ulcer formation, particularly with infection, needs immediate attention and I will refer patients with foot ulceration to the multidisciplinary foot care team immediately. Reading this article has made me reflect on how to alter my practice to enhance care giving. I intend to study diabetes further, and perform thorough foot care assessment as part of the healthcare review of a patient with diabetes, ensuring that I follow recent guidelines and acknowledge my limitations NS Sue Francis is a practice nurse at Grange Medical Centre, West Yorkshire
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 50 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
NURSING october :: vol 28without no 9 :: permission. 2013 61 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 24, 2015. For personal use only. No30 other uses Copyright © 2015 RCNi Ltd. All rights reserved.
