Barriers and enablers to delivering preventative and early intervention footcare to people with diabetes: a scoping review of healthcare professionals' perceptions

2019 ◽  
Vol 25 (6) ◽  
pp. 517 ◽  
Author(s):  
Leanne Mullan ◽  
Andrea Driscoll ◽  
Karen Wynter ◽  
Bodil Rasmussen
Keyword(s):  
Primary Care ◽  
Early Intervention ◽  
English Language ◽  
Healthcare Professionals ◽  
Implementation Challenges ◽  
Barriers And Enablers ◽  
Primary Care Health ◽  
Care Health ◽  
Foot Disease ◽  
Definition Of

The aim of this study is to examine barriers and enablers to delivering preventative and early intervention footcare to people with diabetes, from the perspective of healthcare professionals within primary care. MEDLINE, CINAHL and Scopus databases, as well as Google Scholar, were searched in September 2018. Inclusion criteria included: English language, qualitative and quantitative studies, since 1998, reporting on barriers or enablers, as reported by primary care health professionals, to delivering preventative or early intervention footcare to people with diabetes. In total, 339 studies were screened. Eight studies met criteria. Perceived barriers to providing footcare included: geographical, administrative and communication factors; referral and care guideline availability and implementation challenges; limited availability of specialists and high-risk foot services; and limited resources including time and funding. Enablers to footcare were: implementation of footcare programs; education; clear definition of staff roles; development of foot assessment reminder systems; and reminders for people with diabetes to remove their shoes at appointments. Barriers and enablers to footcare are multifaceted. Healthcare professionals are affected by health system and individual factors. By implementing strategies to address barriers to footcare delivery, it is possible to improve outcomes for people with diabetes, thus reducing the effect of diabetes-related foot disease.

scholarly journals Recording COVID-19 consultations: review of symptoms, risk factors, and proposed SNOMED CT terms

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101125
Author(s):  
Bhautesh Dinesh Jani ◽  
Jill P Pell ◽  
Dylan McGagh ◽  
Harshana Liyanage ◽  
Dave Kelly ◽  
...  
Keyword(s):  
Primary Care ◽  
Data Collection ◽  
Health Conditions ◽  
Normalisation Process Theory ◽  
Snomed Ct ◽  
Implementation Challenges ◽  
Key Stakeholders ◽  
Primary Care Health ◽  
Care Health ◽  
Meta Analyses

BackgroundThere is an urgent need for epidemiological research in primary care to develop risk assessment processes for patients presenting with COVID-19, but lack of a standardised approach to data collection is a significant barrier to implementation.AimTo collate a list of relevant symptoms, assessment items, demographics, and lifestyle and health conditions associated with COVID-19, and match these data items with corresponding SNOMED CT clinical terms to support the development and implementation of consultation templates.Design & settingPublished and preprint literature for systematic reviews, meta-analyses, and clinical guidelines describing the symptoms, assessment items, demographics, and/or lifestyle and health conditions associated with COVID-19 and its complications were reviewed. Corresponding clinical concepts from SNOMED CT, a widely used structured clinical vocabulary for electronic primary care health records, were identified.MethodGuidelines and published and unpublished reviews (N = 61) were utilised to collate a list of relevant data items for COVID-19 consultations. The NHS Digital SNOMED CT Browser was used to identify concept and descriptive identifiers. Key implementation challenges were conceptualised through a Normalisation Process Theory (NPT) lens.ResultsIn total, 32 symptoms, eight demographic and lifestyle features, 25 health conditions, and 20 assessment items relevant to COVID-19 were identified, with proposed corresponding SNOMED CT concepts. These data items can be adapted into a consultation template for COVID-19. Key implementation challenges include: 1) engaging with key stakeholders to achieve ’buy in’; and 2) ensuring any template is usable within practice settings.ConclusionConsultation templates for COVID-19 are needed to standardise data collection, facilitate research and learning, and potentially improve quality of care for COVID-19.

scholarly journals Do electronic reminders alter recorded diagnoses in primary care office-hours practices of health centers: A register-based study in a Finnish city

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Mika Lehto ◽  
Kaisu Pitkälä ◽  
Ossi Rahkonen ◽  
Merja K Laine ◽  
Marko Raina ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Health Centers ◽  
Health Record ◽  
Record System ◽  
Electronic Reminder ◽  
Primary Health ◽  
Primary Care Health ◽  
Before And After ◽  
Care Health

Objectives: One purpose of electronic reminders is improvement of the quality of documentation in office-hours primary care. The aim of this study was to evaluate how implementation of electronic reminders alters the rate and/or content of diagnostic data recorded by primary care physicians in office-hours practices in primary care health centers. Methods: The present work is a register-based longitudinal follow-up study with a before-and-after design. An electronic reminder was installed in the electronic health record system of the primary health care of a Finnish city to remind physicians to include the diagnosis code of the visit in the health record. The report generator of the electronic health record system provided monthly figures for the number of various recorded diagnoses by using the International Classification of Diseases, 10th edition, and the total number of visits to primary care physicians, thus allowing the calculation of the recording rate of diagnoses on a monthly basis. The distribution of diagnoses before and after implementing ERs was also compared. Results: After the introduction of the electronic reminder, the rate of diagnosis recording by primary care physicians increased clearly from 39.7% to 87.2% (p < 0.001). The intervention enhanced the recording rate of symptomatic diagnoses (group R) and some chronic diseases such as hypertension, type 2 diabetes and other soft tissue disorders. Recording rate of diagnoses related to diseases of the respiratory system (group J), injuries, poisoning and certain other consequences of external causes (group S), and diseases of single body region of the musculoskeletal system and connective tissue (group M) decreased after the implementation of electronic reminders. Conclusion: Electronic reminders may alter the contents and extent of recorded diagnosis data in office-hours practices of the primary care health centers. They were found to have an influence on the recording rates of diagnoses related to chronic diseases. Electronic reminders may be a useful tool in primary health care when attempting to change the behavior of primary care physicians.

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