Latest News 21 February 2019 | A bedside clinic providing foot care for Counties Manukau Health patients during dialysis treatment, is helping to reduce lower-limb amputations.
The Feet for Life programme was developed in response to high numbers of CM Health dialysis patients having digital or below-the-knee amputations, as a result of their condition.
Research showed barriers to specialist podiatry treatment, such as waiting times of up to six weeks, and transport and health challenges resulting in patients failing to attend clinics, were contributing to the problem.
Under Feet for Life, renal nurses are trained to assess foot wounds and monitor infection, and concerning cases are referred to a podiatrist who removes damaged tissue from wounds, and prescribes wound care and pressure management. Since its inception in June 2013, Feet for Life has maintained a reduction in lower limb amputations of renal patients with diabetes by at least 10 per cent; and the rates of patients who did not attend appointments (DNA) have gone from 12 per cent to less than 1 per cent.
Podiatrist, Lawrence Kingi, who is funded under the scheme for 20 hours a week, says running the clinic while patients are receiving dialysis provides the chance to respond quickly to any wound deterioration.
“This includes bringing in vascular clinicians when blood flow to the lower limbs is compromised, which has resulted in a significant reduction in the incidence of amputations,” he says.
“I’d say around 270 patients have been seen with some form of open lesion or deep ulceration with the potential to amputate,” he says, noting the average cost per amputation is $22,000.
“Amputation can have a huge impact on a person’s life. The loss of independence is a burden to most and the cosmetic embarrassment can also be a struggle.”
Working with Lawrence on the Feet for Life team is renal physician Viliami Tutone - charge nurse manager, Rowena Schofield - dialysis Manukau SuperClinic, Amie Hwang - charge nurse manager, AMC dialysis, and Jubeda Shah- charge nurse manager of Ward One.