Development of a nurse-provided health system strategy for diabetic foot care

A nurse-provided university health system diabetic foot screening/education /treatment program evaluated 403 patients in the initial 12 months of devel opment. All patients were provided individualized foot-specific patient edu cation, varying in Intensity with the magnitude of their risk status. One h undred and forty-five (36%) were categorized as being at risk for the devel opment of a diabetic foot ulcer. Improper footwear capable of producing foo t ulceration was recorded in 268 (66.5%) of the enrollees. Seven patients w ith previously undiagnosed Charcot foot disorder were identified. Eighty-th ree of the enrollees were seen at least once in follow-up. Sixty-one (73%) used improper footwear at the initial evaluation, which was decreased to 36 (43%) at the first follow-up visit. Nurse-provided foot-specific diabetic screening and education, combined wit h protective footwear, has been shown to be a cost- and resource-effective method of decreasing the rate of diabetic foot ulcers, and the risk for eve ntual lower extremity amputation.