RESIZE TEXT: Small Font Size Regular Font Size Large Font Size

Provide Organizational Support

a. Multi-disciplinary Team Intervention Referral Criteria Checklist

  • Primary Care Physician
  • Community Nursing
  • Advanced Wound Specialist
  • Nurse Practitioner
  • Infectious Disease Specialist
  • Vascular Surgeon
  • Orthopedic Surgeon
  • Dermatologist
  • Plastic Surgeon
  • Internist/Endocrinologist
  • Nephrologist
  • Cardiologist
  • Opthalmologist/Optometrist
  • Mental Health Specialist
  • Psychologist/Psychiatrist
  • Social worker
  • Registered Dietitian
  • Pharmacist
  • Occupational Therapist

b. Steps to Avoid Amputation

c. Patient, Caregiver and Healthcare Provider Teaching and Learning Resources

d. Discharge or Transfer Planning and Communications

Regardless of the method of providing the information (e.g. Care Connect, photocopy or Discharge Summary), it is agreed that the following information is critical in providing seamless care when individuals who have diabetic foot ulcers are being discharged or transferred to a different care setting:
  • Current blood work result
  • Vascular study results
  • Current and past treatment regimes
  • Any surgical intervention?
  • Identify ongoing nutritional or glycemic control support
  • Community referrals as required- Diabetic Educator, Diabetes Association, Local foot care clinics
  • Reinforce risk factors /diabetic foot ulcer prevention/proper foot wear
  • Assess client/caregivers adherence and understanding to treatment plan
  • Refer to self-management if appropriate
Appropriate documents that need to be shared:
  • identify need to reassess ABPI and /TBPI in 6 months
  • Lower leg assessment results
  • Recent vascular study results (eg. ABPI, TBPI, Transcutaneous Oxygen Pressure (TcPo2), Laser Doppler Flowmetry, Doppler Arterial
  • Waveforms or Segmental Doppler Pressure studies)
  • Relevant consultation notes
  • Diagnostic results
  • Post and current treatment and education plan
  • List of appropriate contact information for ongoing needs
If wound closed or eschar is stable (in arterial disease) send discharge summary outlining outstanding issues and teaching completed to:
  • Referral source
  • Most responsible physician (MRP)/Nurse Practitioner (NP)

e. Waterloo Wellington Integrated Wound Care Program Evidence-Based Wound Care Diabetic Foot Ulcer

We value your feedback, and would appreciate if you took a few moments to respond to some questions.

Yes No Maybe Later