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  • 1.
    Hussein, Ahmed Ghaleb Abdul
    Malmö högskola, Faculty of Health and Society (HS).
    Diabetesfoten hos inneliggande strokepatienter: risk, omfattning, och omvårdnadsåtgärder2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    THE DIABETIC FOOT IN HOSPITALIZED STROKE PATIENTS: RISK, PREVELANCE AND NURSING ACTIONS. BACKGROUND: Complications in the foot is the most serious one of the diabetes. Often, this leads to expensive treatments and amputation. Stroke results in loss or limitation of previous physiological, psychological and social activities and including a reduced ability to protect their feet and perform self-care. Stroke patients with diabetes have a high risk of injury in the paralyzed side of the body. Impaired mobility is a risk factor that can cause patient harm. On the nursing ward for stroke patients the nurse can through good nursing intervention and preventive actions contribute to the risk of developing damage to their feet in stroke patients decreases. AIM: The aim of the study is to explore the prevalence of diabetic foot at a neurological clinic and review the nursing documentation of preventions actions in stroke patients with diabetes with regard to the risk of developing foot ulcers. METHOD: A retrospective medical record review study with quantitative and qualitative approach. The study was conducted at a neurological clinic at a university hospital in southern Sweden. All the records (n = 101) of stroke patients with diabetes who were treated at the clinic from 1 January 2015 to 20 December 2015. The examination was conducted using Global Trigger Tool (GTT). Data analysis was divided into two parts: the descriptive statistical analysis and manifest content analysis. RESULTS: Median age is 78 years (41-93). Women (n = 40), men (n = 61). Journal review showed insufficient documentation. Risk assessment for foot ulcers was not documented in any of the journals. Patients with documented foot ulcer (n= 3), the localization of ulcers is on the same side as the patient is paralyzed. Prevention and nursing actions, (n = 12) documented action in bed, (n = 0) documented actions in the chair. According IWGDF risk classification (n =12) identified as having risk factors for foot problem and foot ulcer. Documentation of nursing process was not followed in the journals. SUMMARY: The patients had high age with multiple comorbidities and paralyzed in the whole or on one side of the body. The localization of foot ulcers is on the same side as the patient is paralyzed. Insufficiency in nursing documentation and prevention work result in risk to patient safety and impaired quality of care. The study provides more knowledge about the risk of the developing foot ulcer for patients with stroke and diabetes who treated in the neurological clinic. The study provide foundation to develop the clinic quality work and ensure patient safety through increasing knowledge to the clinic about diabetic complications and guidelines, nursing documentation in accordance with the nursing process and critical thinking of nursing. More studies of foot ulcers in stroke patients are recommended. Keywords: diabetes mellitus, diabetes foot ulcers, documentation, Global Trigger Tool, journal examination, nursing, prevention,

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