Evaluating the Effectiveness of Evidence-Based Nursing Interventions in Preventing and Managing Diabetic Foot Complications: A Systematic Review

Diabetic foot ulcers have emerged as a global health concern in recent decades, leading to severe complications in patients with type 2 diabetes. This study aimed to review and summarize the current evidence-based guidelines for foot care in individuals with type 2 diabetes. Using the PICO framework, a systematic review was conducted, sourcing guidelines from various English databases and the Mahidol University library system. Databases, including PubMed, CINAHL, ScienceDirect, were searched for guidelines published from 2004 to 2014. A total of 33 guidelines were retrieved, with 12 deemed relevant to the study's objectives. These included four international guidelines, seven national guidelines, and one consensus statement. The AGREE II instrument was employed to appraise all selected guidelines. Guideline synthesis revealed five key activities for effective foot care in type 2 diabetes patients: 1) foot assessment, encompassing inspection and examination of the feet; 2) risk assessment and classification into different categories; 3) provision of information to patients and their families regarding foot care, appropriate footwear, and nail care; 4) guidance on blood glucose control; and 5) the referral of at-risk patients to multidisciplinary healthcare teams, particularly in cases of potential serious wound infection and peripheral arterial disease (PAD). This study underscores the importance of utilizing these evidence-based recommendations to develop foot care guidelines tailored to clinical settings in Bangladesh. Strategies for effective guideline implementation should be a priority, with a strong emphasis on distributing these guidelines among healthcare personnel, including nurses, to enhance the quality of care provided to type 2 diabetes patients.