Translation Models

Diabetes is an international crisis and considered to be one of the Global Burden Diseases (The U.S. Burden of Disease Collaborators, 2018). In the primary care setting, translating the evidence of preventing Diabetic Foot Ulcers is done by introducing self-care education to primary care patients with a transitional Model. Almost 1/3 of people with diabetes acquire foot ulcers, and of these ulcers, 3/4 are avoidable (Bus & Van Netten, 2016). Therefore, it is incredibly essential to translate this evidence into action to prevent foot loss by amputation and, ultimately, early mortality. The Knowledge to Action Model (KTA) is used to translate all the evidence-based research knowledge on diabetic foot care into action in the clinic setting. KTA has two main components, “Knowledge Creation” and the “Action Cycle.” Using KTA, we already have numerous research available on diabetic foot care, funneled to identify a knowledge gap or problem. Knowing the problem, we must implement the second phase, which has seven stages called the Action Cycle. It can be continuous and go in either direction if necessary.

Stage One: The problem of poor diabetic foot care education on one-third of diabetics has been identified, and a knowledge gap exists between patients and caregivers.

Stage Two: The local setting of primary care with a high population of Hispanic patients with diabetes.

Stage Three: One of the possible barriers to this self-care program will be staffing and proper nurses’ training as educators. Also, the time it takes to teach patients. Another obstacle will be the patient’s willingness to learn and perform appropriate foot care daily.  This project’s facilitators will be the primary care providers and management at a micro, meso, and macro-level. The facilitators would help ensure proper staffing and more time allotted in the clinic for foot care sessions during diabetic visits.

Stage Four: Implement the project by educating nurses on diabetes and its effect on the body. The second part of implementation would be having the nurses teach foot care to Hispanic Diabetic patients at every visit. Using a transtheoretical Change Model at this stage would be appropriate.

Stage Five: In this stage, we would monitor the nurses’ knowledge using surveys and observation. We would measure the patients learning with a teach-back method and questionnaire.

Stage Six: Evaluating the outcomes might take a little longer to see results. Still, we should assess feedback from the nurses, podiatrist providers, and patients on the knowledge and care provided through surveys and questionnaires.

Stage Seven: This stage is not a final step but rather a step where knowledge is sustained with continuous updates and reassessments. This stage would keep the program fresh, and the key stakeholders would play the role of being receptive to the new norm and not become disengaged.

The resources needed for this project would be a clinical educator to train nurses on the effects and care of diabetic patients, mostly on foot self-care: foot care literature, handouts, and a small foot care kit for patients.  The kit would consist of a lotion, liquid soap, Emory boards, monofilament, and a mirror. This kit would cost about 12-15 dollars per unit. Key stakeholders such as pharmaceutical companies or diabetic organizations and community leaders would be instrumental in funding each diabetic patient with a self-care kit.

References

Bus, S. A., & van Netten, J. J. (2016). A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable. Diabetes/metabolism research and reviews, 32 Suppl 1, 195–200. https://doi.org/10.1002/dmrr.2738

The U.S. Burden of Disease Collaborators. (2018). The state of U.S. health, 1990–2016 burden of diseases, injuries, and risk factors among U.S. states. JAMA, 319(14), 1444–1472. https://doi.org/10.1001/jama.2018.0158 (Links to an external site.)

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