Stepping Up: Enhancing Provider Knowledge to Reduce Diabetic Foot Ulcers

Abstract

Purpose: This quality improvement (QI) project aimed to enhance the implementation of diabetic foot exams in primary care settings by utilizing an evidence-based assessment tool, thereby reducing the incidence of diabetic foot ulcers (DFUs). Background: Diabetes affects approximately 38.1 million U.S. adults, with a significant proportion at risk for DFUs, a complication that can lead to severe morbidity and increased healthcare costs (Centers for Disease Control and Prevention [CDC], 2020). Despite the recognized importance of regular foot examinations, only about 62.9% of primary care providers conduct diabetic foot screenings, falling short of the CMS benchmark of 76.17% (Cooksey, 2020). This project addresses the need for improved awareness and adherence to screening protocols among healthcare providers to mitigate the risks associated with DFUs, particularly in high-risk populations. Methods: This quality improvement project used both quantitative and qualitative approaches to assess whether Inlow's 60-Second Diabetic Foot Screen could enhance providers' knowledge and increase early detection of diabetic foot ulcers. Pre- and post-surveys with Likert-scale questions were distributed to providers during an educational session to quantify knowledge and comfort with the screening. The IHI Model for Improvement guided project implementation, with the PDSA cycle supporting continuous evaluation and adaptation to sustain improvements in foot ulcer prevention. Results: Initially, all providers reported no familiarity with the tool, but post-intervention survey results indicated an increase in providers' familiarity and comfort with Inlow’s 60-Second Diabetic Foot Screening tool post-intervention. Confidence in using the tool also increased, contributing to improved patient interactions, with one provider expressing intent to adopt it routinely in practice. Conclusion: Implementing Inlow's 60-Second Diabetic Foot Screening tool enhances early detection of diabetic foot complications. Educating providers on routine examinations and the tool's efficient use facilitates the timely identification of ulcers, reduces serious complications, and promotes better patient self-management. Despite a limited sample size, findings underscore the need for ongoing education and clinic-wide awareness to improve practices and patient outcomes in diabetic foot health management.