Improving Diabetic Foot Exam among African American Veterans in a Primary Care Clinic
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Conducting diabetic foot exams and documenting them according to American Diabetic Association recommendations is inadequate, leading to poorer outcomes. The provision of diabetic education enhances self-efficacy and improves results, but performance is suboptimal. Empowering patients has improved patient-physician collaboration, resulting in more remarkable patient outcomes and physician and patient satisfaction. It is a quasi-experimental quality improvement project to enhance the completion of diabetic foot exams and education with a brochure and to improve patients' diabetic psychosocial self-efficacy in African American military veterans with diabetes. The Veterans Health Administration facility in the Midwest is the project site and included a retrospective chart review from September 2020 to December 2020 on 27 participants and a prospective chart audit on the same group from September 2021 to December 2021. Each patient received an Ask Me brochure, a Diabetes Empowerment Scale – Short Form questionnaire pre-and post-intervention to measure self-efficacy, and feedback post-intervention-only survey to measure patient experience. The results showed that patients who obtained comprehensive annual foot examination increased from 37% to 78% (P=.001), and education on diabetic foot examination soared to 82% from 44% (P=.002). Eighty-five percent of the participants demonstrated improved psychosocial self-efficacy scores (Z =−4.197, p < .001), and the documentation of both education and foot exams improved fostering early detection and reduction in complications and cost of diabetes-related foot disease.
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Open Access (fully available)