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Addressing Diabetic Foot Ulcerations in a Primary Care Clinic
Abstract
ABSTRACT
Purpose: The overarching purpose of this quality improvement project was to improve patient outcomes specific to diabetes foot care by implementing a diabetes foot care protocol.Background: Although diabetic foot complications such as the formation of ulcerations are preventable, they are still prevalent and a common incidence amongst diabetic patients (Mariam et al., 2017). Education and prevention strategies in the primary care setting related to diabetic foot care can reduce and prevent the development of foot ulcerations in diabetic patients (Gallman, Conner & Johnson, 2017). In order to respond to the necessity of more consistent foot examinations, the American Diabetes Association generated Standards of Medical Care-2018. Recommendations include the inspection of diabetic patient’s feet at every visit, an annual comprehensive foot examination to identify risk factors prognostic of ulcerations, foot abnormalities and amputations, as well as endorsements for a multidisciplinary approach and referrals (ADA, 2018).Sample/Setting: The population sample consisted of diabetic patients from an outpatient family practice clinic in a Midwest metropolitan area. A convenience sample was collected consisting of adult patients diagnosed with diabetes between the ages of 18 to 95 years. The sample size was approximately 70 patients who were seen within this clinic.Methods: A quality improvement project with a retrospective chart analysis, a provider educational and intervention portion, and a post intervention chart review was conducted on diabetic patients in a suburban primary care clinic.Results: A Chi-square test was completed and significant results were identified in the following domains: increased documentation of annual comprehensive foot exams post intervention, increase in foot inspection documentation and increase in documented diabetes education.Conclusion: The implementation of the diabetic foot care protocol yielded significant results thereby improving provider compliance in foot assessments and patient outcomes specific to diabetes care.
Purpose: The overarching purpose of this quality improvement project was to improve patient outcomes specific to diabetes foot care by implementing a diabetes foot care protocol.Background: Although diabetic foot complications such as the formation of ulcerations are preventable, they are still prevalent and a common incidence amongst diabetic patients (Mariam et al., 2017). Education and prevention strategies in the primary care setting related to diabetic foot care can reduce and prevent the development of foot ulcerations in diabetic patients (Gallman, Conner & Johnson, 2017). In order to respond to the necessity of more consistent foot examinations, the American Diabetes Association generated Standards of Medical Care-2018. Recommendations include the inspection of diabetic patient’s feet at every visit, an annual comprehensive foot examination to identify risk factors prognostic of ulcerations, foot abnormalities and amputations, as well as endorsements for a multidisciplinary approach and referrals (ADA, 2018).Sample/Setting: The population sample consisted of diabetic patients from an outpatient family practice clinic in a Midwest metropolitan area. A convenience sample was collected consisting of adult patients diagnosed with diabetes between the ages of 18 to 95 years. The sample size was approximately 70 patients who were seen within this clinic.Methods: A quality improvement project with a retrospective chart analysis, a provider educational and intervention portion, and a post intervention chart review was conducted on diabetic patients in a suburban primary care clinic.Results: A Chi-square test was completed and significant results were identified in the following domains: increased documentation of annual comprehensive foot exams post intervention, increase in foot inspection documentation and increase in documented diabetes education.Conclusion: The implementation of the diabetic foot care protocol yielded significant results thereby improving provider compliance in foot assessments and patient outcomes specific to diabetes care.