Implementation of a Diabetic Visual Foot Assessment in a Primary Care Setting

Purpose: The purpose of this project was to implement a visual foot assessment by health care providers at every visit for patients with diabetes. The objective was to identify common foot conditions that may predispose patients to further complications that might lead to amputation. Methods: The Plan-Do-Check-Act (PDCA) cycle was implemented in an internal medicine clinic. The records of fifty-two patients with a diagnosis of type 2 diabetes that were seen in the clinic during a two week period were reviewed to determine the percentage of foot assessments completed and the type of foot conditions identified. Results: At the office encounter, 86.5% of patients received a visual foot assessment during the two week period. Twenty-three of the fifty-two patients had at least one foot condition or complication identified. Conditions identified were acute swelling, skin breakdown, callus, digital deformity, amputation, dystrophic nails, and dry skin. Conclusion: The recommendation is that health care providers follow standards of care by performing a visual foot inspection at every encounter. The implication for practice is that foot conditions can be identified early, thus allowing for proper implementation of interventions in an effort to decrease amputations.