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  • Subject Name : Medical Science

Introduction

Evidence-based practice (EBP) is a judicious and conscientious use of the best evidence in collaboration with clinical expertise and patient value. It also assists to guide all healthcare decisions. There are mainly three elements of EBP and these are mentioned below. First is the best available evidence, although the EBP consists of more than just applying the best available evidence. Several barriers and concerns are used in EBP. It majorly revolves around research and findings which are present. The second and third important concepts are the skills and knowledge of clinicians, other is the needs and wants of the patient. This is a highly important project as in this project, the care interventions which are present would be improved in wound healing in diabetes patients. To take care of diabetes patients, it is highly necessary to follow the steps of EBP, so it can be used in a highly efficient manner (Li et al., 2019).

Background

Patients with diabetes are at high risk of infection and due to diabetes healing is also delayed. The wounds in diabetic patients need to be taken care of in an effective manner, foot ulcers should be prevented and timely treatment needs to be adopted. While providing care it is highly essential that the steps of EBP need to be followed. Wound care interventions need to be followed efficiently and effectively. People with diabetic foot ulcers greatly influence the quality of life of patients. It has an impact on the psychological factor, and how it is important for the healthcare team (Cardoso et al., 2021). The patient suffers from moderate to high-quality levels of emotional well-being, social functioning, and fatigue or energy. In addition to it, it also increases the mortality rate of low-limb amputation. Along with the patients, it will also impact the healthcare provider, because the care process is also affected. The quality of physical activity of the patient is affected and it needs to be taken care of (Wang et al., 2022).

The Table of Studies Included

Jayalakshmi, M.S., Thenmozhi, P., & Vijayaragavan, R. (2020). Impact of the chronic wound on quality of life among diabetic foot ulcer patients in a selected hospital of Guwahati, Assam, India. Ayu, 41(1), 19–23. https://doi.org/10.4103/ayu.AYU_33_20,

Cross-sectional study, Level 1

In this study, the diabetic foot ulcer is a high mortality factor among diabetic patients, it also has a massive impact on the quality of life. The major aim of the study is to investigate the impact of diabetic foot ulcers among diabetes patients. This is a cross-sectional study and descriptive study. The study was conducted in a private hospital which is situated in Assam. Foot complications have a huge impact on quality of life. All the domains of life like psychological, physical, economic, and social life are affected. The present study aims to examine the foot ulcer taking different components of the patients. The study includes exclusion and inclusion criteria, data collection needs to be defined.

Abate, T.W., Enyew, A., Gebrie, F., & Bayuh, H. (2020). Nurses' knowledge and attitude towards diabetes foot care in Bahir Dar, North West Ethiopia. Heliyon, 6(11), e05552. https://doi.org/10.1016/j.heliyon.2020.e05552

Cross-sectional study, Level 2

In another study the management of diabetic ulcers is being discussed, it is a highly serious complication of diabetes and it results in some significant mortality and morbidity. The mortality rate which is associated with the development of DFU is estimated to be about 5% in the initial 12 months. The five-year mortality is recorded to be 42%. The management of DFU includes EBP, and all the steps are followed accordingly. Some practices which are followed are dressings to facilitate a moist wound environment and to take control, surgical debridement, infection and glycemic control, wound off-loading, vascular assessment, and infection and glycemic control. All these practices which are mentioned above are coordinated in the best manner, and these will help in the multidisciplinary diabetic foot wound. There are adjuvant therapies that are adopted and these are highly useful. Some adjuvant therapies which are adopted are human growth factors, topical agents and dressings, negative pressure wound therapy, oxygen therapies, and acellular bioproducts.

Everett, E., & Mathioudakis, N. (2018). Update on the management of diabetic foot ulcers. Annals of the New York Academy of Sciences, 1411(1), 153–165. https://doi.org/10.1111/nyas.13569

Systematic review, Level 1

In another study the management of diabetic ulcers is being discussed, it is a highly serious complication of diabetes and it results in some significant mortality and morbidity. The mortality rate which is associated with the development of DFU is estimated to be about 5% in the initial 12 months. The five-year mortality is recorded to be 42%. The management of DFU includes EBP, and all the steps are followed accordingly. Some practices which are followed are dressings to facilitate a moist wound environment and to take control, surgical debridement, infection and glycemic control, wound off-loading, vascular assessment, and infection and glycemic control. All these practices which are mentioned above are coordinated in the best manner, and these will help in the multidisciplinary diabetic foot wound. There are adjuvant therapies that are adopted and these are highly useful. Some adjuvant therapies which are adopted are human growth factors, topical agents and dressings, negative pressure wound therapy, oxygen therapies, and acellular bioproducts.

Yamas, 2020.

Systematic review, Level 1

The major focus is on nurse knowledge and attitude toward diabetic foot care and how they can improve it. All the adults diagnosed with diabetes are advised to undergo a comprehensive foot evaluation, at least once a year. The attitude and knowledge of nurses should be taken care of. The study is aimed to assess the knowledge and attitude of diabetes and its care process.

Synthesis of Evidence

All the evidence which are selected should be adequate and a standard should be set. All the basic guidelines need to be followed and work needs to be done effectively. The research paper which is selected should follow all the standards and it should be highly effective. Several pieces of evidence are present and all this evidence needs to be treated.

Recommendations

There are several recommendations which should be followed, one and the most important is to maintain a healthy lifestyle. A healthy lifestyle is highly important, it will ensure that all the basic requirements related to it are followed. A healthy lifestyle will include regular physical activity and healthy eating habits. Regular physical activity will ensure the health of the heart is maintained and the whole body functioning can be maintained. Other than this following a healthy diet is also essential, with a healthy diet, health is maintained. Any fat accumulation will be avoided, hence, it is essential. With a healthy diet, several aspects need to be taken care of. Healthy diets protect people against several noncommunicable diseases such as heart disease, cancer, and diabetes (Bornstein et al., 2020). For a healthy diet, a variety of food needs to be consumed, the food should be less in salt and sugar, trans fat should be low and only essential fat should be presented. A well-balanced diet needs to be followed, this will help the body to be active throughout the day. Nutrients are required for growth and repair, it will help the person to stay strong and healthy, this will help them to stay healthy and strong. All the disease-related illnesses and cancer need to be treated. Overall health is improved, and several aspects are worked on. The body's functioning is improved hence, health is maintained, when the health is improved, other provisions are also taken care of. When the person is physically active, it will improve the brain health. Other than this, the risk of the disease is also reduced. Following regular physical activity will improve the ability to be involved in daily life activities. Adults who mainly sit for a longer duration of time have the ability to be involved in vigorous to moderate physical activity, this will also help them to gain various health benefits (Yu et al., 2022).

Oxygen therapy needs to be provided, this will help to maintain the oxygen level in the body. This therapy is important in the wound care regime in the diabetic foot ulcer. Other than this negative pressure wound therapy is provided in the clinincal practice, it has demonstrated favourable outcome. This treatment option will help to reduce the wound size and promote healing rate. There is an inclusion of hyperbaric oxygen therapy in the treatment plan for diabetic foot. This therapy option is used as a well-established treatment for the decompression sickness.

Conclusion

Evidence-based practice (EBP) is defined as the judicious and conscientious use of the best evidence in collaboration with clinical expertise and patient value. In addition to it, it also assists to guide all healthcare decisions. Patients who are been diagnosed with diabetes are at a much high risk of infection and due to diabetes healing is also delayed. The wounds in diabetic patients need to be taken care of in an effective manner, foot ulcers should be prevented and timely treatment needs to be adopted. From the research, several recommendations need to be followed such as the implementation of a healthy diet or healthy lifestyle. Following regular physicals will improve the ability.

References

Abate, T.W., Enyew, A., Gebrie, F., & Bayuh, H. (2020). Nurses' knowledge and attitude towards diabetes foot care in Bahir Dar, North West Ethiopia. Heliyon, 6(11), e05552. https://doi.org/10.1016/j.heliyon.2020.e05552

Bornstein, S. R., Rubino, F., Khunti, K., Mingrone, G., Hopkins, D., Birkenfeld, A.L., Boehm, B., Amiel, S., Holt, R.I., Skyler, J.S., DeVries, J. H., Renard, E., Eckel, R.H., Zimmet, P., Alberti, K.G., Vidal, J., Geloneze, B., Chan, J.C., Ji, L., & Ludwig, B. (2020). Practical recommendations for the management of diabetes in patients with COVID-19. The Lancet. Diabetes & endocrinology8(6), 546–550. https://doi.org/10.1016/S2213-8587(20)30152-2

Cardoso, D., Couto, F., Cardoso, A.F., Bobrowicz-Campos, E., Santos, L., Rodrigues, R., Coutinho, V., Pinto, D., Ramis, M.A., Rodrigues, M.A., & Apóstolo, J. (2021). The effectiveness of an evidence-based practice (EBP) educational program on undergraduate nursing students' ebp knowledge and skills: A cluster randomized control trial. International Journal of Environmental Research and Public Health18(1), 293. https://doi.org/10.3390/ijerph18010293

Everett, E., & Mathioudakis, N. (2018). Update on management of diabetic foot ulcers. Annals of the New York Academy of Sciences, 1411(1), 153–165. https://doi.org/10.1111/nyas.13569

Jayalakshmi, M.S., Thenmozhi, P., & Vijayaragavan, R. (2020). Impact of chronic wound on quality of life among diabetic foot ulcer patients in a selected hospital of Guwahati, Assam, India. Ayu, 41(1), 19–23. https://doi.org/10.4103/ayu.AYU_33_20

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine98(39), e17209. https://doi.org/10.1097/MD.0000000000017209

Wang, X., Yuan, C. X., Xu, B., & Yu, Z. (2022). Diabetic foot ulcers: Classification, risk factors and management. World Journal of Diabetes13(12), 1049–1065. https://doi.org/10.4239/wjd.v13.i12.1049

Yamas, K. V. (2020). Nurses’ knowledge and attitude towards diabetic foot care in a secondary health care centre in Sudan. Nursing and Midwifery1(01), 15-18.

Yu, J., Lee, S.H., & Kim, M.K. (2022). Recent updates to clinical practice guidelines for diabetes mellitus. Endocrinology and Metabolism (Seoul, Korea)37(1), 26–37. https://doi.org/10.3803/EnM.2022.105

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