Improving Healthcare Providers’ Adherence to Foot Exams for Type-II Diabetic Patients in a Primary Care Clinic

Abstract

Foot wounds are complications of type II diabetes mellitus (T2DM), which may be prevented with proper foot assessments. Diabetic foot exams are not consistently performed despite evidence-based screening tools available. Objective: To determine if the implementation of an electronic medical record (EMR) alert using Inlow’s 60-Second Diabetic Foot Screen would impact the number of diabetic foot exams performed among T2DM patients at a primary care level. Method: A quantitative quasi-experiment design was used to implement an electronic medical record (EMR) alert using Inlow’s 60-Second Diabetic Foot Screen to impact the frequencies of diabetic foot exams. Sample size was 65, n=35 in the comparative group and n= 30 in the implementation group. Population consisted of male and female patients ages 18 years and older, diagnosed with T2DM within the last two years, no previous diabetic foot exams or received foot care education, did not perform self-reported foot inspections, and were able to read, write, and speak English. A chi square test was run to analyze the frequencies of foot exams between groups. Results: A Pearson’s chi-square showed a statistically significant increase in the foot exams X2 (1, N=65) = 5.286, p= 0.02 using an EMR alert with Inlow’s 60-Second Diabetic Foot screen. Conclusion: EMR alerts increase performance of diabetic foot exams. Recommendations include sustainment of the program, dissemination of results, and further investigation of the impact of EMR alerts. Keywords: Diabetes, Foot screening, EMR alert