Diabetic Foot Infection Failure ModesOutcomesStrategies Chart by gsa16110


									                   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
                                                           •   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-
                                                           •   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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