The explosion in telehealth during the COVID-19 pandemic inspired Cizik School of Nursing at UTHealth Assistant Professor Hsiao-Hui “Joyce” Ju, DNP, RN, FNP-BC, to apply it to a crucial aspect of diabetes treatment – foot care.
Diabetes is the leading cause of lower-limb amputations. “This is all preventable,” Ju said.
High blood sugar levels can lead to nerve and vascular damage, causing patients to lose sensation in their extremities. Unless they learn how to perform daily checks, they may not notice small cuts, scratches, or blisters, which then can become infected. Reduced circulation means such wounds can take longer to heal in patients with diabetes.
The clinic where Ju will conduct the project did not employ telehealth until the pandemic made it a necessity.
“This technology is really a powerful tool,” Ju said. “Patients are not missing their appointments. With telehealth, everyone just logs in right away. Patients love it. It lets them get in touch with the providers more easily.”
Daily self-screenings are key to preventing infections that can lead to invasive procedures, but teaching patients how to check their own feet can easily get lost when addressing more urgent issues during an office visit, Ju said.
“Because of COVID, I realized we could use the technology to do something that is quite often overlooked,” she said.
Ju has received a $2,000 pilot grant from the Endocrine Nurses Society for a pilot study titled “Feasibility of a patient-centered, telehealth-delivered diabetes foot care educational program.” Nurses are at the forefront of promoting self-care and positive lifestyle behaviors, she noted in her abstract.
Ju plans to recruit 65 adult patients experiencing diabetes to participate in a series of Zoom sessions to learn about foot care. The program begins with a one-on-one telehealth visit to assess the patient’s needs. Next, participants will be sorted by age for group sessions, with a final teleconference incorporating gaming as fun way to apply what they have learned. She also intends to create closed social media groups where participants can share their experiences with one another.
Eventually, Ju hopes to develop a patient-friendly app to provide information and reminders about daily foot care.