Module quiz The NHS England module quiz is currently being updated with with the addition of a new case study. We expect to be back tomorrow. Thank you for your patience. (N.B. all fields are compulsory)Name Dr.MissMr.Mrs.Ms.Prof.Rev. Title First name Last name Email NHS BoardNHS Bath and North East Somerset, Swindon and Wiltshire ICBNHS Bristol, North Somerset and South Gloucestershire ICBNHS Cornwall and Isles of Scilly ICBNHS Devon ICBNHS Dorset ICBNHS Gloucestershire ICBNHS Somerset ICBNHS England (not listed above)NHS ScotlandNHS Northern IrelandNHS WalesNot applicableYour place of work (i.e. GP practice or hospital)Your professionConsultantDistrict NurseDoctorHealth Care AssistantHealth Care WorkerOrthotistParamedicPhysiotherapistPodiatristPodiatry AssistantPodiatry TechnicianPractice NurseRegistered NurseSocial Care WorkerStudent - MedicalStudent - NursingStudent - TherapySupport WorkerTherapy AssistantOtherIf you selected Other, please specifyDo you currently carry out foot screening? Yes No Patient A Jennifer is 24 years old and lives alone with her cat. She enjoys swimming and playing netball for her local netball team. Jennifer was diagnosed with type 1 diabetes at the age of 12 and has no other major health problems. Instructions You will be asked to fill out the form based on the patient details provided on the paper. Each form section will be populated as if the patient does not have any problems, you must read the patient information and amend accordingly. When you have filled out the form you will then be asked to make your own risk assessment of this patient. Patient details Jennifer's details have already been filled in so you can proceed to next section. Name: HUME, Jennifer CHI: 191255MNU Age: 24 Type of diabetes: 1Screening date DD slash MM slash YYYY Attendance: Attended and seen GP Practice name: Hope Medical Centre Postal address: 2 Albion Avenue, Capital City Postcode: GX9 5GH Amputation Jennifer has no amputations so the amputations section is therefore not activated. Right Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Left Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Risk factors Jennifer has no significant structural deformity or significant callus, and shows no signs of active ulceration or previous ulceration. She is able to self care. No other risk factors are identified. Significant structural abnormality of foot: Present | Absent ✓ Significant foot callus: Present | Absent ✓ Active ulceration: Yes | No ✓ Previous ulceration: Yes | No ✓ Able to or has help to self care: Yes ✓ | No Receiving renal replacement therapy: Yes | No ✓ Other risk (specify): n/a Vascular screening Jennifer has both peripheral pulses present in each foot. No intermittent claudication or previous vascular intervention. You will need to select 'either present' for the Right and Left.RightPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓LeftPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓ Neurological screening Jennifer has sensation in all 6 sites. 10 gram monofilament sites: Present = Absent = Loss of protective sensation = No Feeling in less than 6 sites? Painful neuropathy: Present | Absent ✓ Risk status Bearing in mind the information you have been given during Jennifer’s foot screening, what is her risk status? Q. What is Jennifer’s risk status? Active High Moderate Low Sorry, you have assigned Jennifer as Active, this is incorrect. Jennifer is not at risk because she presents with no significant foot problems. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Jennifer as High, this is incorrect. Jennifer is not at risk because she presents with no significant foot problems. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Jennifer as Moderate, this is incorrect. Jennifer is not at risk because she presents with no significant foot problems. Please undertake this screening again bearing in mind all the information provided. Low risk Well done, Jennifer is Low risk because she presents with no significant foot problems. Low The recommended action for low risk patients: Annual screening by a suitably trained Health Care Worker. Tell people that they are at low risk of foot ulceration and agree a self-management plan. Provide written and verbal information about diabetes and the importance of blood glucose control, basic foot care and footwear. Advise them that they could progress to moderate or high risk. Provide information about foot emergencies and who to contact. Referral status/education Jennifer requires no further referral so no changes need to be made to this section. Verbal and written foot education will be advised regarding self management. Education Written foot health education given: Yes ✓ | No Verbal foot health education given: Yes ✓ | No Form submission Thank you for completing this foot screening form, select 'Submit' to continue to the next patient. You have scored: 1/1 Patient B William is 62 years old. He was diagnosed with type 2 diabetes 2 years ago. He retired last year and enjoys working in his garden. Instructions You will be asked to fill out the form based on the patient details provided on the paper. Each form section will be populated as if the patient does not have any problems, you must read the patient information and amend accordingly. When you have filled out the form you will then be asked to make your own risk assessment of this patient. Patient details William's details have already been filled in so you can proceed to next section. Name: MARTINSON, William CHI: 1812453HNG Age: 62 Type of diabetes: 2Screening date DD slash MM slash YYYY Attendance: Attended and seen GP Practice name: Grange Medical Centre Postal address: 54 Rose Gardens, Bath Postcode: BA9 6BH Amputation William has no amputations so the amputations section is therefore not activated. Right Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Left Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Risk factors William presents with claw toe deformity and finds it difficult to buy shoes to fit comfortably. He has significant callus on the sole of his right foot which causes him some discomfort. He does not attend a podiatrist. He shows no signs of active ulceration and has not had previous ulceration. He is able to self care and has no other risk factors. You will need to update the fields accordingly.Significant structural abnormality Present Absent Significant foot callus Present Absent Active ulceration Yes No Previous ulceration Yes No Able to or has help to self care Yes No Receiving renal replacement therapy Yes No Other risk Yes No Other risk (specify) Vascular screening William has both peripheral pulses present in each foot. No intermittent claudication or previous vascular intervention is present. You will need to select 'either present' for the Right and Left.RightRight peripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓LeftLeft peripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓ Neurological screening William has sensation in all 6 sites. He does not have painful neuropathy. 10 gram monofilament sites: Present = Absent = Loss of protective sensation = No Feeling in less than 6 sites? Painful neuropathy: Present | Absent ✓ Risk status Bearing in mind the information you have been given during William’s foot screening, what is his risk status? Q. What is William's risk status? Active High Moderate Low Sorry, you have assigned William as Active, this is incorrect. William is at risk because he presents William presents with claw toe deformity and significant callus. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned William as High risk, this is incorrect. William is at risk because he presents William presents with claw toe deformity and significant callus. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned William as Low risk, this is incorrect. William is at risk because he presents William presents with claw toe deformity and significant callus. Please undertake this screening again bearing in mind all the information provided. Moderate risk Well done, William is Moderate risk because he presents with claw toe deformity and significant callus. Moderate The recommended action for moderate risk patients: Tell people that they are at moderate risk of foot ulceration and refer to the foot protection service for first assessment (within 6-8 weeks). The foot protection service should; assess the feet every 3-6 months, give advice about and provide skin and nail care of the feet. Assess foot biomechanics, give footwear advice and consider providing insoles and specialist footwear. Assess lower limb vascular status. Liaise with other healthcare professionals about diabetes management and reducing the risk of cardiovascular disease. Provide information about foot emergencies and who to contact. People in hospital should be given a device to offload heel pressure. Referral status/education William should be referred to the podiatrist for callus debridement and to request an assessment for prescription footwear. Verbal and written foot education will be given by the podiatrist including information regarding self management. Refer William to: Dietetic District nurse Ophthalmologist Orthopaedic Orthotic Podiatry Practice nurse Vascular Other Other specify:Education Written foot health education given: Yes ✓ | No Verbal foot health education given: Yes ✓ | No Form submission Thank you for completing this foot screening form, select 'Submit' to continue to the next patient. You have scored: 2/2 Patient C Lynne is a 52 year old and was diagnosed with type 2 diabetes when she presented at her GP practice 9 months ago with an ulcer on the sole of her right foot. She did not know how it happened and it was not painful. She was immediately referred to her local Multidisciplinary diabetic foot clinic and after treatment the ulcer has subsequently healed. She now attends a podiatrist at her local health centre every 6 weeks for podiatry treatment. Instructions You will be asked to fill out the form based on the patient details provided on the paper. Each form section will be populated as if the patient does not have any problems, you must read the patient information and amend accordingly. When you have filled out the form you will then be asked to make your own risk assessment of this patient. Patient details Lynne's details have already been filled in so you can proceed to next section. Name: PETERS, Lynne CHI: 1516467PKG Age: 52 Type of diabetes: 2Screening date DD slash MM slash YYYY Attendance: Attended and seen GP Practice name: Orchard Medical Practice Postal address: 73 Bailey Crescent, Bristol Postcode: BS8 1BG Amputation Lynne has no amputations so the amputations section is therefore not activated. Right Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Left Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Risk factors Lynne has significant callus on the soles of her feet. She has no significant structural abnormalities and no active ulceration. The ulcer she was suffering from has now healed. She is able to self care. No other risk factors are identified. You will need to update the fields accordingly.Significant structural abnormality of foot Present Absent Significant foot callus Present Absent Active ulceration Yes No Previous ulceration Yes No Able to or has help to self care Yes No Receiving renal replacement therapy Yes No Other risk Yes No Other (please specify) Vascular screening Lynne has both peripheral pulses present in each foot. No intermittent claudication or previous vascular intervention. You will need to select 'either present' for the Right and Left.RightPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓LeftPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓ Neurological screening Lynne could not feel the monofilament on her R&L 1st hallux, and R1st Metatarsal head. You will need to pick and click on the correct image below which reflects the findings of Lynne’s neurological screening. 10 gram monofilament sites: Present = Absent = Loss of protective sensation = Yes Feeling in less than 6 sites?Which image reflects Lynne's sites? A B C D Painful Neuropathy Present Absent Risk status Bearing in mind the information you have been given during Lynne’s foot screening, what is her risk status? Q. What is Lynne's risk status? Active High Moderate Low Sorry, you have assigned Lynne as Active, this is incorrect. Lynne is at risk because she has had previous ulceration, she has significant callus, and she suffers from neuropathy. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Lynne as Moderate, this is incorrect. Lynne is at risk because she has had previous ulceration, she has significant callus, and she suffers from neuropathy. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Lynne as Low, this is incorrect. Lynne is at risk because she has had previous ulceration, she has significant callus, and she suffers from neuropathy. Please undertake this screening again bearing in mind all the information provided. High Well done, Lynne is High risk because she has had previous ulceration, she has significant callus, and she suffers from neuropathy. High The recommended action for high risk patients: Tell people that they are at high risk of foot ulceration and refer to the foot protection service for first assessment (within 2-4 weeks). The foot protection service should; assess the feet and give advice and care frequently (1-2 months) or very frequently (1-2 weeks) where there is immediate concern. The foot protection service will assess foot biomechanics, give footwear advice and consider providing Insoles and speciality footwear. Assess lower limb vascular status. Liaise with other healthcare professionals about diabetes management and reducing the risk of cardiovascular disease. People in hospital should be given a device to offload heel pressure. Referral status/education Lynne is currently attending a specialist podiatrist for regular podiatric treatment/management and she is given further advice/education at each podiatry visit. No changes need to be made to this section. Education Written foot health education given: Yes ✓ | No Verbal foot health education given: Yes ✓ | No Form submission Thank you for completing this foot screening form, select 'Submit' to continue to the next patient. You have scored: 3/3 Patient D Reyansh is 72 years old and was diagnosed with Type 2 diabetes when he was 63 and considerably overweight. He had an ulcer on his R3rd toe 4 years ago which failed to heal and resulted in the toe being amputated. InstructionsYou will be asked to fill out the form based on the patient details provided on the paper. Each form section will be populated as if the patient does not have any problems, you must read the patient information and amend accordingly. When you have filled out the form you will then be asked to make your own risk assessment of this patient. Patient details Reyansh's details have already been filled in so you can proceed to next section. Name: KUMAR, Reyansh CHI: 7230663KJP Age: 72 Type of diabetes: 2Screening date DD slash MM slash YYYY Attendance: Attended and seen GP Practice name: Oaks Medical Centre Postal address: 62/1 Park Terrace, Plymouth Postcode: PL12 5RV Amputation Reyansh had an ulcer on his R3rd toe 4 years ago which failed to heal and resulted in the toe being amputated on 27/8/2017. You will need to update the fields accordingly.Right footSelect oneNoneDigitTranstibialTransfemoralDate of amputation 27/08/2017Diabetes related amputation Yes No Left footSelect oneNoneDigitTranstibialTransfemoralDate of amputation: n/a Diabetes related amputation: Yes | No ✓ Risk factors Reyansh has no significant callus or significant structural abnormalities and no active ulceration. He had a previous ulcer on his toe which resulted in it being amputated. He is unable to self care as he suffers from retinopathy which has resulted in him becoming visually impaired. You will need to update the fields accordingly.Significant structural abnormality of foot Present Absent Significant foot callus Present Absent Active ulceration Yes No Previous ulceration Yes No Able to or has help to self care Yes No Receiving renal replacement therapy Yes No Other risk Yes No Other (please specify) Vascular screening Reyansh has both pulses absent in his R foot, posterior tibial pulse present on L foot. He does not suffer from intermittent claudication but has had previous vascular intervention in his right leg. You will need to update the fields accordingly.RightPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication Yes No Previous vascular intervention Yes No LeftPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication Yes No Previous vascular intervention Yes No Neurological screening Reyansh can feel all 6 monofilament sites. 10 gram monofilament sites: Present = Absent = Loss of protective sensation = No Feeling in less than 6 sites? Painful neuropathy: Present | Absent ✓ Risk status Bearing in mind the information you have been given during Reyansh’s foot screening, what is his risk status? Q. What is Reyansh's risk status? Active High Moderate Low Sorry, you have assigned Reyansh as Active, this is incorrect. Reyansh is at risk because he has had a previous amputation, he suffers from PVD and absent pulses in his right foot, and he suffered from previous ulceration prior to his amputation. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Reyansh as Moderate, this is incorrect. Reyansh is at risk because he has had a previous amputation, he suffers from PVD and absent pulses in his right foot, and he suffered from previous ulceration prior to his amputation. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Reyansh as Low, this is incorrect. Reyansh is at risk because he has had a previous amputation, he suffers from PVD and absent pulses in his right foot, and he suffered from previous ulceration prior to his amputation. Please undertake this screening again bearing in mind all the information provided. High Well done, Reyansh is high risk because he has had a previous amputation, he suffers from PVD and absent pulses in his right foot, and he suffered from previous ulceration prior to his amputation. High The recommended action for high risk patients: Tell people that they are at high risk of foot ulceration and refer to the foot protection service for first assessment (within 2-4 weeks). The foot protection service should; assess the feet and give advice and care frequently (1-2 months) or very frequently (1-2 weeks) where there is immediate concern. The foot protection service will assess foot biomechanics, give footwear advice and consider providing Insoles and speciality footwear. Assess lower limb vascular status. Liaise with other healthcare professionals about diabetes management and reducing the risk of cardiovascular disease. People in hospital should be given a device to offload heel pressure. Referral status/education Reyansh is currently attending a specialist podiatrist for regular podiatric treatment/management. He is still struggling to control his weight and would benefit from being referred to a dietician.Refer Reyansh to: Dietetic District nurse Ophthalmologist Orthopaedic Orthotic Podiatry Practice nurse Vascular Other Other specify:Education Written foot health education given: Yes ✓ | No Verbal foot health education given: Yes ✓ | No Form submission Thank you for completing this foot screening form, select 'Submit' to continue to the next patient. You have scored: 4/4 Patient E John is 37 years old and was diagnosed with Type 1 when he was 12. He lives with his partner has two young children and keeps fit by visiting the gym 3 times a week. InstructionsYou will be asked to fill out the form based on the patient details provided on the paper. Each form section will be populated as if the patient does not have any problems, you must read the patient information and amend accordingly. When you have filled out the form you will then be asked to make your own risk assessment of this patient. Patient details John's details have already been filled in so you can proceed to next section. Name: CAPALDI, John CHI: 886406631YRF Age: 37 Type of diabetes: 1Screening date DD slash MM slash YYYY Attendance: Attended and seen GP Practice name: Teviot Medical Centre Postal address: 3 Leaburn Crescent, Bournemouth Postcode: BH9 7JU Amputation John has no amputations. Right Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Left Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Risk factors John has no significant callus or significant structural abnormalities. He has no active ulceration or previous ulceration. He is able to self care. No other risk factors have been identified. Significant structural abnormality of foot: Present | Absent ✓ Significant foot callus: Present | Absent ✓ Active ulceration: Yes | No ✓ Previous ulceration: Yes | No ✓ Able to or has help to self care: Yes ✓ | No Receiving renal replacement therapy: Yes | No ✓ Other risk (specify): n/a Vascular screening John has both pulses present on both feet. No intermittent claudication or previous vascular intervention. You will need to select 'either present' for the Right and Left.RightPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓LeftPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓ Neurological screening John can feel all 6 monofilament sites. 10 gram monofilament sites: Present = Absent = Loss of protective sensation = No Feeling in less than 6 sites? Painful neuropathy: Present | Absent ✓ Risk status Bearing in mind the information you have been given during John’s foot screening, what is his risk status? Q. What is John's risk status? Active High Moderate Low Sorry, you have assigned John as Active, this is incorrect. John is not at risk because he has no risk factors that would put him at risk of ulceration. Please undertake this screening again bearing in mind all the information provided. Sorry, you have assigned John as High, this is incorrect. John is not at risk because he has no risk factors that would put him at risk of ulceration. Please undertake this screening again bearing in mind all the information provided. Sorry, you have assigned John as Moderate, this is incorrect. John is not at risk because he has no risk factors that would put him at risk of ulceration. Please undertake this screening again bearing in mind all the information provided. Low risk Well done, John is low risk because he has no risk factors that would put him at risk of ulceration. Low The recommended action for low risk patients: Annual screening by a suitably trained Health Care Worker. Tell people that they are at low risk of foot ulceration and agree a self-management plan. Provide written and verbal information about diabetes and the importance of blood glucose control, basic foot care and footwear. Advise them that they could progress to moderate or high risk. Provide information about foot emergencies and who to contact. Referral status/education John does not attend a podiatrist but has his feet screened each year by the practice nurse in his GP practice who gives him advice on self management. No changes need to be made to this section. Education Written foot health education given: Yes ✓ | No Verbal foot health education given: Yes ✓ | No Form submission Thank you for completing this foot screening form, select 'Submit' to continue to the next patient. You have scored: 5/5 Patient F Donald is 59 years old and has suffered from poorly controlled Type 2 diabetes for 5 years. He took early retirement 2 years ago and lives at home with his wife Mary. InstructionsYou will be asked to fill out the form based on the patient details provided on the paper. Each form section will be populated as if the patient does not have any problems, you must read the patient information and amend accordingly. When you have filled out the form you will then be asked to make your own risk assessment of this patient. Patient details Donald's details have already been filled in so you can proceed to next section. Name: SMITH-BROWN, Donald CHI: 437857RDH Age: 59 Type of diabetes: 2Screening date DD slash MM slash YYYY Attendance: Attended and seen GP Practice name: Springwell Medical Centre Postal address: 64 Beech Road, Truro Postcode: TR13 5PY Amputation Donald has no amputations. Right Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Left Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Risk factors Donald has no significant callus or significant structural abnormalities. He has no active ulceration or previous ulceration. He is able to self care. No other risk factors have been identified. Significant structural abnormality of foot: Present | Absent ✓ Significant foot callus: Present | Absent ✓ Active ulceration: Yes | No ✓ Previous ulceration: Yes | No ✓ Able to or has help to self care: Yes ✓ | No Receiving renal replacement therapy: Yes | No ✓ Other risk (specify): n/a Vascular screening Donald has both pulses present on both feet. No intermittent claudication or previous vascular intervention. You will need to select 'either present' for the Right and Left.RightPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓LeftPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓ Neurological screening Donald could not feel the monofilament on his R1st hallux, L1st hallux and L1st metatarsal head. You will need to update the fields accordingly. You will need to pick and click on the correct image below which reflects the findings of Donald’s neurological screening. 10 gram monofilament sites: Present = Absent = Loss of protective sensation = Yes Feeling in less than 6 sites?Which image reflect's Donald's sites? A B C D Painful neuropathy Present Absent Risk status Bearing in mind the information you have been given during Donald’s foot screening, what is his risk status? Q. What is Donald's risk status? Active High Moderate Low Sorry, you have assigned Donald as Active, this is incorrect. Donald is at risk because he suffers from neuropathy as he could only feel 3/6 of the monofilament sites. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Donald as High, this is incorrect. Donald is at risk because he suffers from neuropathy as he could only feel 3/6 of the monofilament sites. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Donald as Low, this is incorrect. Donald is at risk because he suffers from neuropathy as he could only feel 3/6 of the monofilament sites. Please undertake this screening again bearing in mind all the information provided. Moderate risk Well done, Donald is Moderate risk because he suffers from neuropathy as he could only feel 3/6 of the monofilament sites. Moderate The recommended action for moderate risk patients: Tell people that they are at moderate risk of foot ulceration and refer to the foot protection service for first assessment (within 6-8 weeks). The foot protection service should; assess the feet every 3-6 months, give advice about and provide skin and nail care of the feet. Assess foot biomechanics, give footwear advice and consider providing insoles and specialist footwear. Assess lower limb vascular status. Liaise with other healthcare professionals about diabetes management and reducing the risk of cardiovascular disease. Provide information about foot emergencies and who to contact. People in hospital should be given a device to offload heel pressure. Referral status/education Donald will need to be referred to a podiatrist as he is moderate risk due to his neuropathy and is currently not attending a podiatrist. Verbal and written foot education will be given regarding his neuropathy.Refer Donald to: Dietetic District nurse Ophthalmologist Orthopaedic Orthotic Podiatry Practice nurse Vascular Other Other specify:Education Written foot health education given: Yes ✓ | No Verbal foot health education given: Yes ✓ | No Form submission Thank you for completing this foot screening form, select 'Submit' to continue to the next patient. You have scored: 6/6 Patient G Magda is 47 years old and lives with her husband and 3 children. Magda was diagnosed with Type 2 diabetes 3 years ago. Her busy lifestyle means she struggles to control diabetes as well as her weight. InstructionsYou will be asked to fill out the form based on the patient details provided on the paper. Each form section will be populated as if the patient does not have any problems, you must read the patient information and amend accordingly. When you have filled out the form you will then be asked to make your own risk assessment of this patient. Patient details Magda's details have already been filled in so you can proceed to next section. Name: ROLOWZKI, Magda CHI: 3756038MSC Age: 47 Type of diabetes: 2Screening date DD slash MM slash YYYY Attendance: Attended and seen GP Practice name: Ashley Medical Centre Postal address: 29 Cross Road, Cheddar Postcode: BS19 9CB Amputation Magda has no amputations so the amputations section is therefore not activated. Right Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Left Amputation: none Date of amputation: n/a Diabetes related amputation: n/a Risk factors Magda has a significant structural deformity and a significant callus, she shows no signs of active ulceration or previous ulceration. She is able to self care. She is undergoing kidney dialysis and has a recorded eGFR <14. No other risk factors are identified. You will need to update the fields accordingly.Significant structural abnormality of foot Present Absent Significant foot callus Present Absent Active ulceration Yes No Previous ulceration Yes No Able to or has help to self care Yes No Receiving renal replacement therapy Yes No Other risk Yes No Other (please specify) Vascular screening Magda has both peripheral pulses present in each foot. No intermittent claudication or previous vascular intervention. You will need to select 'either present' for the Right and Left.RightPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓LeftPeripheral pulses (posterior tibial or dorsalis pedis) Either present Both absent Intermittent claudication: Yes | No ✓ Previous vascular intervention: Yes | No ✓ Neurological screening Magda has sensation in all 6 sites. 10 gram monofilament sites: Present = Absent = Loss of protective sensation = No Feeling in less than 6 sites? Painful neuropathy: Present | Absent ✓ Risk status Bearing in mind the information you have been given during Magda’s foot screening, what is her risk status? Q. What is Magda's risk status? Active High Moderate Low Sorry, you have assigned Magda as Active, this is incorrect. Magda is at risk because she presents with a significant structural deformity, a significant callus, on renal replacement therapy and an eGFR <14. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Magda as Moderate, this is incorrect. Magda is at risk because she presents with a significant structural deformity, a significant callus, on renal replacement therapy and an eGFR <14. Please undertake this screening again bearing in mind all the information provided.Sorry, you have assigned Magda as Low, this is incorrect. Magda is at risk because she presents with a significant structural deformity, a significant callus, on renal replacement therapy and an eGFR <14. Please undertake this screening again bearing in mind all the information provided. High risk Well done, Magda is at risk because she presents with a significant structural deformity, a significant callus, is undergoing kidney dialysis and has a recorded eGFR <14. High The recommended action for high risk patients: Tell people that they are at high risk of foot ulceration and refer to the foot protection service for first assessment (within 2-4 weeks). The foot protection service should; assess the feet and give advice and care frequently (1-2 months) or very frequently (1-2 weeks) where there is immediate concern. The foot protection service will assess foot biomechanics, give footwear advice and consider providing Insoles and speciality footwear. Assess lower limb vascular status. Liaise with other healthcare professionals about diabetes management and reducing the risk of cardiovascular disease. People in hospital should be given a device to offload heel pressure. Referral status/education As Magda struggles to control her weight she should be referred to the dietician. Verbal and written foot education will be given and she is referred for education regarding self management.Refer Magda to Dietetic District nurse Ophthalmologist Orthopaedic Orthotic Podiatry Practice nurse Vascular Other Other (please specify)Education Written foot health education given: Yes ✓ | No Verbal foot health education given: Yes ✓ | No Form submission Thank you for completing this foot screening form, select 'Submit' to complete the test. You have scored: 7/7 Module quiz (NHS England) Module quiz (NHS England)Module quiz
