Diabetic foot ulcers represent a formidable challenge in healthcare, impacting patients' quality of life and putting strain on healthcare resources (Subrata and Phuphaibul, 2019; Lo et al, 2023; Oe et al, 2024). Addressing the complexities of diabetic foot ulcer care requires not just clinical expertise, but also an unwavering commitment to patient safety, spearheaded by effective healthcare management and leadership (Peterson et al, 2023).
Championing best practice
Healthcare services are responsible for cultivating an environment where safety is not merely a guideline, but an intrinsic value, deeply embedded in every aspect of care delivery (Singh et al, 2024). Effective diabetic foot ulcer care hinges on the meticulous implementation of evidence-based practices, protocols and innovation (Nurhidayah and Seaharattanapatum, 2021; Vargas Guerrero et al, 2024). This includes standardised procedures for comprehensive wound assessment, rigorous infection prevention and control measures, and multidisciplinary team working (Ogbeide et al, 2024).
Health professionals and leaders must champion the adoption of best practice guidelines and ensure that they are applied consistently across care settings (Pettersen et al, 2024). This requires clear pathways of care, with standardised order sets and robust documentation systems that facilitate strong communication and continuity of care (Morena et al, 2022). Health professionals must also be supported by their managers, through the provision of sufficient resources, to deliver safe and effective care; this encompasses equipment, supplies and staffing (Parand et al, 2014).
Simply implementing protocols is not enough – delivering safe diabetic foot ulcer care means actively creating and maintaining a culture that prioritises patient safety at every level (Purwanti et al, 2023). This means cultivating an environment of open communication in which health professionals feel empowered to raise concerns without fear of reprisal (Toseef et al, 2022).
There should be channels for both staff and patients to give feedback, so that potential safety risks can be identified and proactive solutions implemented (Crans et al, 2022). Regular morbidity and mortality reviews, coupled with root cause analyses of adverse events, are crucial for identifying weaknesses and implementing targeted improvements (Martin-Delgado et al, 2020). Healthcare organisations can support a culture of continuous improvement by learning from their mistakes and prioritising patient safety (Hilverda et al, 2023).
A proactive approach to risk identification and prevention is crucial to diabetic foot ulcer care (Pérez-Panero et al, 2019). Health professionals must empower patients with diabetes to understand the importance of daily foot care, proper footwear and regular self-examination (Crawford et al, 2020). They will likely need to collaborate and communicate across different services, as patients with diabetic foot ulcers often require input from multiple professionals and may transition between various care settings (Winocour, 2014; Modha, 2021).
Practices should set clear protocols for sharing information about patients' wound status, treatment plans and education across care settings, involving clinicians as much as possible (Conde-Montero et al, 2024). This may involve implementing shared electronic health record systems, or developing standardised referral processes (Azamar-Alonso et al, 2019).
Supporting health professionals
The care of patients with diabetic foot ulcers must be well co-ordinated, with safe transitions between services and minimisation of the risk of miscommunication. This requires a commitment to continuous professional development and competency building (Hughes et al, 2022). Health professionals involved in diabetic foot ulcer management require specialised knowledge and skills (Ju et al, 2024), and should be supported to access ongoing education and training opportunities (Pallin et al, 2023). This may include participation in relevant conferences, workshops and certification programmes (Ayadurai et al, 2019; Nikpour et al, 2023). Investing in the professional growth of clinical teams could enhance the quality and safety of care delivered to patients with diabetic foot ulcers.
Overall, ensuring patient safety in diabetic foot ulcer care is not a passive endeavour; it requires active, engaged and innovative clinical practice and leadership. Healthcare professionals must be supported to stay up to date with evidence-based procedures, and to participate in a culture of open communication and learning. Prioritising these principles is key to delivering reliable, responsive and safe care to patients with diabetic foot ulcers.