Primary Care Providers' Knowledge of Strategies to Prevent Diabetic Foot Ulcers

Abstract

Background: Screening for Diabetic Foot Ulcers in the primary care setting can lead to good outcomes for patient and prevent diabetic foot ulcers. Annual screening can detect high-risk patients who are more prone to develop foot ulcers. These patients should then be screened with every visit to prevent a major complication of diabetes, which is a diabetic foot ulcer. Objective: To promote foot examinations in the primary care setting for patients with diabetes who are at high risk of developing a diabetic foot ulcer. Design: A quantitative methodology applying a quality improvement (QI) model was created to examine primary care providers’ knowledge, barriers, and facilitators to foot examination in high-risk patients with diabetes. Participants: Five primary care providers (physicians and nurse practitioners). Setting: A physician owned primary care office in Glendale, Arizona. Measurement: A 19-item survey comprised of Likert-type and open-ended questions was created. Analysis was conducted in Excel. Results: The providers demonstrated adequate baseline knowledge about high-risk patients and foot examinations. Opportunities for improvement were identified and included a system to prompt performance of foot exams and clarification as to who is responsible for performing the foot exams. Potential solutions for improvement were discussed with the clinic representatives on the QI team. Conclusion: Diabetes is a chronic condition and strategies to prevent complications, particularly diabetic foot ulcers, improve patient outcomes and contribute to the delivery of high quality care. As a result of this project, clarification about responsibility for foot examinations and recommendations for a process improvement to prompt performance of foot exams will be made to the practice.