Wat te doen met het diabetes guidance document anno 2015 in de praktijk? : Samen Sterk & Samen SNEL.

Transcription

1 Wat te doen met het diabetes guidance document anno 2015 in de praktijk? : Samen Sterk & Samen SNEL. Dr. Kristien Van Acker, diabetoloog Chimay, Voorzitter IWGDF & IDF Consultative Section on the Diabetic Foot.

2 Inhoud lezing 1. Objectief lezing 2. IWGDF- IDF 3. IWGDF-guidance document 4. Kunst van implementeren 5. Efficiënt verwijzen in optimale verwijzingstijd 6. Take home messages ; key-messages

3 1.Objectief van lezing Kennis :diabetes voet Pre-ulcus/ ulcus/ post ulcus fase Overdracht van deze kennis? Implementatie: gaat verder dan enkel kennisoverdracht Inzicht in medische organisatie Trilogie: welke partners? Wondbehandelaar- patiënt- specialist-

4 2. IWGDF-IDF? International Working Group on the Diabetic Foot 1996 IDF Consultative Section on the Diabetic Foot 2000

5 Objectives of IWGDF The aim of the IWGDF is to create awareness of the disease and to improve the management and prevention of the diabetic foot.

6 Activities of IWGDF Networking and public relations sessions/ 7000users 4,5 min /session 6

7 Representatives 7

8 Activities of IWGDF Implementation programs from Step By Step to TtFT courses Diabetic Foot Care assistant programs

9 Dr. Z. G. Abbas

10 Dr. Z. G. Abbas

11 Melbourne IDF conference 2013 Change of Chair IWGDF from Karel Bakker to Kristien

12 Development of an evidence-based global consensus The 2015 IWGDF Guidance documents K. Bakker; J. Apelqvist; B. A. Lipsky; J. J. van Netten; N. C. Schaper

13 Guidance - Menu

14 Guidance Detailed Menu

15 Prevention

16 Wound Healing

17 Guidance 2015

18 4.Kunst van implementeren

19 Understanding the pre-perand post- ulcer phase Pre ulcer Ulcer Post-ulcer Ulcer 28/11/

20 Understanding the pre-per- and post- ulcer phase Pre ulcer Ulcer Post-ulcer Amputation 28/11/

21 Understanding the pre-per- and postulcer phase New Ulcer Pre ulcer Ulcer Post-ulcer RELAPS 28/11/

22 Intervention programs/implementation guidelines on different levels Hospital Patient & lesions Healing Diabetic Foot Clinic 22

23 RISICO VOETEN

24 EDUCATION!!

25 Intervention programs/implementation guidelines on different levels Hospital Patient & lesions Healing Diabetic Foot Clinic 25

26 Improved survival of the diabetic foot: the role of a specialized foot clinic Edmonds et al. Q J Med 1986

27 How to establish a diabetic foot clinic? Diabetologist Nurse Patient Max Spraul, Noordwijkerhout, 1991

28 How to establish a diabetic foot clinic? Diabetologist Nurse Angiologist Vascular surgeon Patient Podiatrist General surgeon Orthopaedic surgeon X-ray specialist Communication! Microbiologist Max Spraul, Noordwijkerhout, 1991

29 Karel Bakker slide

30 Interdisciplinary team: Integrate separate discipline approaches into a single consultation.

31 Interdisciplinary team: Integrate separate discipline approaches into a single consultation. That is, the patient-history taking, the team, together with the patient, conducts assessment, diagnosis, intervention and short- and long-term management goals at the one time.

32 Intervention programs/implementation guidelines on different levels Hospital Patient & lesions Healing Primary Care Diabetic Foot Clinic 32

33 Integrated care Community Nurses Foot Protection Team Multidisciplinary foot care team In-patient service Skills Knowledge Respect Co-operation Communication Awareness GP practices Neil Baker slide

34 Efficiënt verwijzen in optimale verwijzingstijd

35 Intervention programs/implementation guidelines on different levels Hospital Patient & lesions Healing Primary Care Diabetic Foot Clinic DELAY in referral=biggest enemy 35

36 Association between ulcer duration at referral and time to healing (n = 772) Begin of lesion Percentage of ulcers Duration of healing (days) Same month 49% 73 Month before 30% 93 > 1 months before 12% 98 > 2 months before 9% 126 Treece et al., 2003

37 Oplossingen?

38 HOE AFSPRAKEN MAKEN IN CORRCETE DOORVERWIJZING? 38

39 A diabetic foot clinic dynamic referral and back referral Pre ulcer phase Ulcer phase Remission phase Patient follow up Primary Care: nurses, GP s, podiatry Communication!

40 We support each other

41 TAKE HOME MESSAGES Kennis delen: guidance document Professionele barriers overstijgen Uw partners kennen en afspraken maken Empowerment van de patiënt Last but not least: voorkomen is beter dan genezen

42 Conclusie: Alle hens aan dek en we hebben geen tijd meer te verliezen en dit schreven we reeds aan de hand van de wereld diabetes dag in 2005: TIME TO ACT.

43 NOW WE HAVE TO CATCH THE FISH 43

44 we can. 44

45 Thank you on behalf of our patients..