Implementing a diabetic foot care program in a primary care clinic
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Diabetes mellitus is a disease that can result in serious microvascular and macrovascular complications if hyperglycemia is not adequately controlled. These complications include a number of lower extremity problems such peripheral artery disease, ulcers, infections, and neuropathy which can lead to amputations. Many of these lower extremity complications can be prevented with early detection of any problems and proper foot care. Previous research has demonstrated that using a diabetic foot care program can reduce the number of foot complications and improve patient outcomes. Thus, the purpose of this project was to implement a comprehensive diabetic foot care program in a primary care clinic to improve foot care practices among primary care providers. The following questions were the focus of the chart review for this project: Did the primary care provider document the diabetic foot exam using the EHR template? Did the primary care provider document all the elements included on the template? Did the primary care provider document that patient education was provided regarding diabetic foot care? The following questions examined the providers’ satisfaction with the project: Do you use the diabetic foot exam template in the EHR to document diabetic foot exams? Do you feel that the diabetic foot exam template is helpful? Do you use the patient teaching handout for diabetic foot education? Would you recommend this program to other providers to implement in their clinic? Do you have any recommendations to improve the diabetic foot care program? Kurt Lewin’s Change Theory was utilized to guide this project and change the foot care practices of primary care providers in the primary care clinic. A retrospective chart review was conducted on a sample of 52 patients with diabetes who received a diabetic foot exam by one of the five participating primary care providers during the four months following the implementation of this project. The results of this project support that implementing a diabetic foot care program in a primary care clinic improved foot care practices among primary care providers. Primary care providers were 100% compliant with using the diabetic foot exam template to document exams and completed all the elements on the template appropriately. Although only 42% of the participants had diabetic foot education documented in their chart, 100% of the providers reported using the patient educational handout. All the providers reported using the diabetic foot exam template and felt that the template was helpful. In addition all the providers noted that they would recommend this program to other providers. No recommendations for improving the program were given by any of the providers. This program presents primary care providers with a framework for improving their practice and obtaining better patient outcomes. It also highlights an opportunity to provide better education for providers and patients with diabetes to improve diabetic foot care.
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Type | DNP Capstone Project |
Acquisition | Self-submission |
Review Type | Faculty Approved: Degree-based Submission |
Format | Text-based Document |
Evidence Level | N/A |
Research Approach | Translational Research/Evidence-based Practice |
Keywords | Diabetes; Foot Care; Primary Care |
CINAHL Subject(s) | Diabetes Education; Diabetes Education--Methods; Diabetic Foot; Diabetic Foot--Prevention and Control; Program Implementation; Primary Health Care |
Grantor | Mississippi University for Women |
Advisor | Gaddis, Lorraine; Wijewardane, Johnnie Sue; Hamill, Terri |
Level | DNP |
Year | 2017 |
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