Diabetic Foot Infection Failure Modes/Outcomes/Strategies Chart Failure Mode DFI Outcome Strategy Hyperglycemia Failure to heal • Diabetic Education Extension of disease • Diabetic Clinic Follow up Amputation • Simplify Regimen • Achieve glycemic control prior to DC • Provide diabetic care supplies Inadequate Wound Care Failure to heal • Patient/Family Education Extension of disease • Home care visits Amputation • Wound clinic appointment • Appropriate foot wear/orthotics • Weight bearing modification • PT/OT evaluation Medication Compliance Failure to heal • Prescribe affordable, generic and once daily Extension of disease antibiotics. Amputation • Pre authorize antibiotics with insurance plan. • PICC line maintenance. • Post discharge pharmacist call • Home health care services • Clear discharge medication list Consultant Reconciliation Loss of continuity • Follow up appointments made pre-discharge Failure to heal • Discharge plan sent to/discussed with all outpatient clinicians involved in care (not just PMD) Health Literacy Failure to heal • Use pre-discharge day as trial run for patient Extension of disease to demonstrate wound care abilities. Amputation • Painstakingly discuss tenets of glycemic ADE control, frequent skin inspection, and limb protection strategies with patient pre- discharge. • Explicit instructions on what to look for and who to call at (4th grade reading level and in patient’s first language). • Provide the patient with your card and instructions for follow up appointments.
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