P-73 Podiatry training on the diabetic foot for nursing and medical staff in the Central East Division of Fiji

Abstract

Our staff were invited to become involved in the Fiji Health Service Improvement Program, an AusAID funded program for the Central East Division of Fiji Ministry of Health. Interviews with key stakeholders and staff revealed that diabetic foot complications are a large concern for staff and locals, and a major burden on the Colonial War Memorial hospital in Suva. Podiatrists developed a training package on the diabetic foot covering basic anatomy, pathophysiology, diabetic foot complications, identification of the ‘at risk’ foot, infection, debridement and wound management skills including choice of appropriate wound dressings. This package was to be delivered to nursing and medical staff, as the podiatry profession is not currently supported in Fiji. Podiatrists conducted their 2 single day courses and additional time was allocated to visit wards, assist staff with outpatient management and meet key stake holders. Primitive means of wound management, along with a poor understanding of how diabetes affects the feet were identified, and infection was noted to be a major complication in many wounds. Three additional visits have been proposed for 2007-2008 but a number of trips have been cancelled due to the civil unrest in the country. The goals of podiatry intervention are to: 1. Specially train nursing staff at the National Centre for Diabetes in the management of the high risk foot including wound management, pressure care and dressings. 2. Educate staff from nursing stations in outlying communities on screening and early identification of diabetes and foot complications and appropriate referral. 3. Reduce hospital length of stay through improved management of foot complications. 4. Advocate for better dressings and equipment. 5. Be a resource for advising on the most effective allocation of the International Diabetes Federation funding that was recently granted to the area.