Cargando…

787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care

BACKGROUND: Interdisciplinary care of diabetic foot ulcers (DFUs) is associated with nearly 40% reduction in major (above ankle) amputations. We developed a curriculum emphasizing interprofessional collaboration (IPC) between Infectious Disease (ID) fellows and Podiatry residents in the care of vete...

Descripción completa

Detalles Bibliográficos
Autores principales: Parikh, Shalvi B, LaMantia, Jamie N, Brennan, Meghan B, Tischendorf, Jessica S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679237/
http://dx.doi.org/10.1093/ofid/ofad500.848
_version_ 1785150547565740032
author Parikh, Shalvi B
LaMantia, Jamie N
Brennan, Meghan B
Tischendorf, Jessica S
author_facet Parikh, Shalvi B
LaMantia, Jamie N
Brennan, Meghan B
Tischendorf, Jessica S
author_sort Parikh, Shalvi B
collection PubMed
description BACKGROUND: Interdisciplinary care of diabetic foot ulcers (DFUs) is associated with nearly 40% reduction in major (above ankle) amputations. We developed a curriculum emphasizing interprofessional collaboration (IPC) between Infectious Disease (ID) fellows and Podiatry residents in the care of veterans with DFUs. METHODS: The curriculum was delivered in two one-hour in-person sessions. The first session provided background on principles of IPC and perspective sharing of other professions through case discussions. The second session, co-facilitated by an ID physician and a podiatrist, allowed ID fellows and podiatry residents to work through DFU cases. We used a quasi-experimental design (Figure 1) and a multipronged assessment designed by applying Miller's pyramid (Figure 2). We used a modified Jefferson Scale of Attitudes toward IPC (Likert scale 1-5, 5 = strongly positive) to measure fellow attitudes, with items subcategorized by themes of shared learning and diversity & ethics. Fellows reported on the frequency of communication with the primary and podiatry team weekly, and charts of veterans with DFUs were reviewed for documentation of ID-specific content (organism and antibiotic plan), as well as non-ID specific plans (glycemic control, vascular status, and biomechanical considerations). Two-sided t-test was used to compare pre-post performance. [Figure: see text] [Figure: see text] RESULTS: Five ID fellows participated. Post-session evaluations suggest the curriculum was viewed favorably. Fellows had strongly positive baseline attitudes toward IPC. Attitudes toward shared learning improved (4.13 vs 4.44, p < 0.01), but diversity & ethics did not (4.86 vs 4.82, p = 0.61). Hospitalizations of seven veterans with DFUs were analyzed pre-intervention and four analyzed post-intervention. ID-specific content and communication with the primary team remained 100% over the study period. Non-ID-specific content documentation remained low (20% vs 11%, p = 0.30). Frequency of communication with podiatry did not change significantly (57% vs 25%, p = 0.35). CONCLUSION: Interdisciplinary didactic sessions were well-received and may improve attitudes toward shared learning, but likely need to be augmented with interprofessional clinical experiences to achieve practice improvements in the care of veterans with DFUs. DISCLOSURES: All Authors: No reported disclosures
format Online
Article
Text
id pubmed-10679237
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-106792372023-11-27 787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care Parikh, Shalvi B LaMantia, Jamie N Brennan, Meghan B Tischendorf, Jessica S Open Forum Infect Dis Abstract BACKGROUND: Interdisciplinary care of diabetic foot ulcers (DFUs) is associated with nearly 40% reduction in major (above ankle) amputations. We developed a curriculum emphasizing interprofessional collaboration (IPC) between Infectious Disease (ID) fellows and Podiatry residents in the care of veterans with DFUs. METHODS: The curriculum was delivered in two one-hour in-person sessions. The first session provided background on principles of IPC and perspective sharing of other professions through case discussions. The second session, co-facilitated by an ID physician and a podiatrist, allowed ID fellows and podiatry residents to work through DFU cases. We used a quasi-experimental design (Figure 1) and a multipronged assessment designed by applying Miller's pyramid (Figure 2). We used a modified Jefferson Scale of Attitudes toward IPC (Likert scale 1-5, 5 = strongly positive) to measure fellow attitudes, with items subcategorized by themes of shared learning and diversity & ethics. Fellows reported on the frequency of communication with the primary and podiatry team weekly, and charts of veterans with DFUs were reviewed for documentation of ID-specific content (organism and antibiotic plan), as well as non-ID specific plans (glycemic control, vascular status, and biomechanical considerations). Two-sided t-test was used to compare pre-post performance. [Figure: see text] [Figure: see text] RESULTS: Five ID fellows participated. Post-session evaluations suggest the curriculum was viewed favorably. Fellows had strongly positive baseline attitudes toward IPC. Attitudes toward shared learning improved (4.13 vs 4.44, p < 0.01), but diversity & ethics did not (4.86 vs 4.82, p = 0.61). Hospitalizations of seven veterans with DFUs were analyzed pre-intervention and four analyzed post-intervention. ID-specific content and communication with the primary team remained 100% over the study period. Non-ID-specific content documentation remained low (20% vs 11%, p = 0.30). Frequency of communication with podiatry did not change significantly (57% vs 25%, p = 0.35). CONCLUSION: Interdisciplinary didactic sessions were well-received and may improve attitudes toward shared learning, but likely need to be augmented with interprofessional clinical experiences to achieve practice improvements in the care of veterans with DFUs. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2023-11-27 /pmc/articles/PMC10679237/ http://dx.doi.org/10.1093/ofid/ofad500.848 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Parikh, Shalvi B
LaMantia, Jamie N
Brennan, Meghan B
Tischendorf, Jessica S
787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care
title 787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care
title_full 787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care
title_fullStr 787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care
title_full_unstemmed 787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care
title_short 787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care
title_sort 787. next steps: teaching future generations an interdisciplinary approach to diabetic foot ulcer care
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679237/
http://dx.doi.org/10.1093/ofid/ofad500.848
work_keys_str_mv AT parikhshalvib 787nextstepsteachingfuturegenerationsaninterdisciplinaryapproachtodiabeticfootulcercare
AT lamantiajamien 787nextstepsteachingfuturegenerationsaninterdisciplinaryapproachtodiabeticfootulcercare
AT brennanmeghanb 787nextstepsteachingfuturegenerationsaninterdisciplinaryapproachtodiabeticfootulcercare
AT tischendorfjessicas 787nextstepsteachingfuturegenerationsaninterdisciplinaryapproachtodiabeticfootulcercare