Date of Award

Spring 5-27-2017

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Karen Sue Hoyt, PhD, FNP-BC, ENP-C FAEN, FANP, FAAN

Abstract

The purpose of this project was to implement the American Diabetes Association (ADA) foot assessment guidelines utilizing an electronic medical record (EMR) template. Aims of this evidence based practice (EBP) project were to improve documentation of the comprehensive diabetic foot exam, increase identification of loss of protective sensation (LOPS), and increase podiatry and vascular surgery referrals. Diabetes Mellitus (DM) causes many health complications. The lifetime risk of foot ulceration in diabetic patients is 25%. The goal of Healthy People 2020 is to increase this number by 10% to a total of 21,617,200 individuals. The ADA recommends annual comprehensive foot exam for all patients with DM. In the clinic, visual foot and sensory exams are performed but currently there was no EMR documentation for the comprehensive diabetic foot exam. This evidence based practice project included randomly selected chart reviews of 180 type 2 DM patients from May 2015 to May 2016. Chart reviews identified if visual and/or sensory foot exams were documented and if referrals were made to podiatry and/or vascular surgery. A comprehensive diabetic foot exam EMR template was created and implemented between August 2016 and December 2016. Data was retrieved tracking the numbers of comprehensive DM foot exams documented. There was a 10% increase in comprehensive diabetic foot exams from August-December 2016. An EMR template for the comprehensive DM foot exam allows for improved documentation which can lead to improved patient outcomes.

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