Work

787. Next Steps: Teaching Future Generations an Interdisciplinary Approach to Diabetic Foot Ulcer Care

Year: 2023

Type: article

Abstract: Background Interdisciplinary care of diabetic foot ulcers (DFUs) is associated with nearly 40% reduction in major (above ankle) amputations. We developed a curriculum emphasizing interprofessional collaboration (IPC) between Infectious Disease (ID) fellows and Podiatry residents in the care of veterans with DFUs. Methods The curriculum was delivered in two one-hour in-person sessions. The first session provided background on principles of IPC and perspective sharing of other professions through case discussions. The second session, co-facilitated by an ID physician and a podiatrist, allowed ID fellows and podiatry residents to work through DFU cases. We used a quasi-experimental design (Figure 1) and a multipronged assessment designed by applying Miller's pyramid (Figure 2). We used a modified Jefferson Scale of Attitudes toward IPC (Likert scale 1-5, 5 = strongly positive) to measure fellow attitudes, with items subcategorized by themes of shared learning and diversity & ethics. Fellows reported on the frequency of communication with the primary and podiatry team weekly, and charts of veterans with DFUs were reviewed for documentation of ID-specific content (organism and antibiotic plan), as well as non-ID specific plans (glycemic control, vascular status, and biomechanical considerations). Two-sided t-test was used to compare pre-post performance. Results Five ID fellows participated. Post-session evaluations suggest the curriculum was viewed favorably. Fellows had strongly positive baseline attitudes toward IPC. Attitudes toward shared learning improved (4.13 vs 4.44, p < 0.01), but diversity & ethics did not (4.86 vs 4.82, p = 0.61). Hospitalizations of seven veterans with DFUs were analyzed pre-intervention and four analyzed post-intervention. ID-specific content and communication with the primary team remained 100% over the study period. Non-ID-specific content documentation remained low (20% vs 11%, p = 0.30). Frequency of communication with podiatry did not change significantly (57% vs 25%, p = 0.35). Conclusion Interdisciplinary didactic sessions were well-received and may improve attitudes toward shared learning, but likely need to be augmented with interprofessional clinical experiences to achieve practice improvements in the care of veterans with DFUs. Disclosures All Authors: No reported disclosures

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofad500.848

Authors: Shalvi B Parikh, Jamie N LaMantia, Meghan B Brennan, Jessica S Tischendorf

Institution: University of Wisconsin–Madison

Language: English

Topic: Interprofessional Education and Collaboration

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,676