Date of Degree

12-2016

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Laura Munoz

Advisor

Danielle Gunter

Advisor

Antonio Cavazos

Abstract

Purpose: To implement guidelines set in 2016, by the American Diabetes Association (ADA), which recommend annual and periodic foot exams for patients with type II diabetes mellitus (T2DM). Background: Uncontrolled diabetes and foot complications can lead to permanent disability, loss of employment often leading to depression and increased morbidities (Szpunar, Minnick, Dako, & Saravolatz, 2014). Significance of Problem: Individuals who are diagnosed with diabetes are at risk for foot ulcers and amputations if not properly managed. Implementation of a foot screening program has been shown to reduce foot ulcers and amputations (Peterson & Virden, 2013). Methods: Annual and periodic foot exams occurred from June 6th through August 12, 2016 at the home of 48 T2DM patients. Early education on how to assess the diabetic foot and document findings was provided to primary healthcare providers and medical assistants with a focus on adherence to ADA recommendations. The outcome of increased ability to assess the feet and document was measured by a chart audit of 48 patient charts. A chart review was conducted for verification of delivery of educational material to the patient along with the completion of foot screening criteria for podiatry referral. Results: Implementation of the ADA guidelines by healthcare providers improved foot care management and documentation by 83% when 40 patients out of 48 received a correct assessment. Conclusions: The Doctor of Nursing Practice project increased adherence to the ADA guidelines improving the diabetic foot screenings and documentation with sustained change and better care to T2DM patients.

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