The Online Journal of Clinical Audits, Vol 5, No 2 (2013)

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The management of diabetic foot infections in a busy district hospital: an audit report

Chioma J Iwu, Becky Mersh, Michael Parkin, Samson O Oyibo


Aims – We audited the management of diabetic foot infections in our District General Hospital after adopting the guidelines produced by the National Institute for Clinical Excellence.


Methods – The admission notes for patients admitted with a diabetic foot infection between January 2011 and September of 2012 were used to fill out the audit questionnaire.


Results – We reviewed 42 patient-admission notes. A majority were male patients with a moderately infected fore-foot ulcer and were referred from their general practitioner. More than three-quarter of patients had investigations and treatment in accordance with the guidelines. However, there was less than adequate documentation of evidence of feet examination and less than adequate documentation of reasons for non-adherence to the antibiotic policy. Ninety percent of patients were seen by a member of the multidisciplinary foot team during admission. The median length of stay in hospital for the patient group was 5.5 days.


Conclusions – There was reasonably good adherence to guidelines in important areas of management. Continued staff education and involvement of the multidisciplinary foot team is essential for improving adherence to guidelines, so as to reduce morbidity, mortality and long hospital stay in patients with diabetic foot infections. 

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