Expanding Professional Roles in Ophthalmology: Innovative Care Models for Nurses and Optometrists
VOLUME 21, 2024
The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review
VOLUME 6, 2023
Amal Dhaifallah Al-Amri, Mawaddah Mubarak Aljohani, Sultan Abdullah AlJahni, Raghad Sultan Alharbi, Mosaad Saad Alsadi, Mohammed Aied Alrehaili
Hind Saleh Alharbi, Ahlam Abdulrahman Altomboktie, Abdulrahman Hedairy Aljohani, Manal Hussain Albatran, Abdullah Alharthi, Tahani Almuqiren
Abstract
The healthcare landscape is continuously evolving, with innovative care models emerging to address challenges in service delivery, particularly in specialist fields like ophthalmology. This article examines how the professional roles of nurses and optometrists are expanding within ophthalmology to enhance patient care, reduce wait times, and address workforce shortages. Through analysis of emerging evidence, this paper explores various task-shifting and task-sharing models, evaluates their safety and efficacy, and discusses the ethical, regulatory, and practical considerations associated with role expansion. The evidence suggests that well-designed nurse-led and optometrist-led services can safely deliver specific ophthalmic procedures and screening, potentially increasing service capacity while maintaining quality of care. However, successful implementation requires appropriate training, clear protocols, supportive regulatory frameworks, and ongoing evaluation. This review provides insights for healthcare planners, administrators, and clinicians seeking to optimize ophthalmology service delivery through innovative professional role expansion.
Keywords :
.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Abstract
Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords :
Diabetic foot ulcer, angiosome, angioplasty