not posed. Reliability data require at least two coders, or pre-defined clas- sification schemes.20 The schemes were based on RNs’ competence description.21 A limitation using a pre-defined scheme is that contex- tual factors might be omitted and that more supportive rather than non-supportive data are reported.20 However, by using their back- grounds as RNs, the research group acknowledged these risks when designing the schemes, and the group agreed on the coding. Data could also be confirmed by the inter- viewed RNs describing similar situa- tions from their different contexts, and the narratives contained plenty of recurrent patterns: repeated experiences from their work as RNs in home nursing.35 The results of this study can, with some caution, be transferred to other home nursing settings in Sweden. All municipalities offer home nursing services regulated by the same legislation.7,8 RNs work under the same competency descrip- tion, including the nursing process, and legal requirements.21
Conclusion There is a need for an improved structure in preventive work on dia- betic foot ulcers. Home nursing organisation needs more long-term care planning, rather than acute interventions. The interviewed RNs work mainly through HCAs. They are informal leaders, educating the HCAs to assess patients’ feet, report deteriorations, and perform off- loading actions. Obtaining footwear and chiropody is delegated to HCAs. Evaluation of foot ulcer preventive interventions is not systematically done. There should be substantial economic savings for the municipali- ties to be made with structured diabetic foot ulcer prevention.17 Maintaining undamaged feet until the end of a patient’s life is in line with working to promote health and
alleviate suffering and, to reduce future workload, the RNs’ foot ulcer preventive work should be acknowl- edged in home nursing.
Declaration of interests There are no conflicts of interest declared.
not posed. Reliability data require at least two coders, or pre-defined clas- sification schemes.20 The schemes were based on RNs’ competence description.21 A limitation using a pre-defined scheme is that contex- tual factors might be omitted and that more supportive rather than non-supportive data are reported.20 However, by using their back- grounds as RNs, the research group acknowledged these risks when designing the schemes, and the group agreed on the coding. Data could also be confirmed by the inter- viewed RNs describing similar situa- tions from their different contexts, and the narratives contained plenty of recurrent patterns: repeated experiences from their work as RNs in home nursing.35 The results of this study can, with some caution, be transferred to other home nursing settings in Sweden. All municipalities offer home nursing services regulated by the same legislation.7,8 RNs work under the same competency descrip- tion, including the nursing process, and legal requirements.21
Conclusion There is a need for an improved structure in preventive work on dia- betic foot ulcers. Home nursing organisation needs more long-term care planning, rather than acute interventions. The interviewed RNs work mainly through HCAs. They are informal leaders, educating the HCAs to assess patients’ feet, report deteriorations, and perform off- loading actions. Obtaining footwear and chiropody is delegated to HCAs. Evaluation of foot ulcer preventive interventions is not systematically done. There should be substantial economic savings for the municipali- ties to be made with structured diabetic foot ulcer prevention.17 Maintaining undamaged feet until the end of a patient’s life is in line with working to promote health and
alleviate suffering and, to reduce future workload, the RNs’ foot ulcer preventive work should be acknowl- edged in home nursing.
Declaration of interests There are no conflicts of interest declared.
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