Development of Assessment and Screening Tool to Assist with Prevention and Identification of Charcot Foot in Type 2 Diabetics

Louise Wade Dnp Rn

doi:10.15226/2374-6890/4/4/00186

Abstract

Development of Assessment and Screening Tool to Assist with Prevention and Identification of Charcot Foot in Type 2 Diabetics by Louise Wade MSN, RN MS, West Texas AM an additional goal was to develop practice guidelines for practitioners to assist in the early recognition, treatment, and referral of adult diabetic patients at risk for Charcot foot. Lippitt’s theory of change was used to guide the project. An interdisciplinary team of stakeholders was assembled to guide development of the tool, algorithm, and practice guidelines. Products were developed in accordance with evidence in current peer-reviewed literature and American Diabetes Association recommendations for Charcot foot diagnosis, treatment, and referral. Content was validated using a scale content validation instrument process to obtain input from experts in the care of Charcot foot. An implementation plan was developed to guide introduction of the products into practice, and an evaluation plan created to determine the extent to which intermediate term outcomes are met using these products. The project may contribute to social change by identifying patients at risk for Charcot foot prior to the onset of the complication, therefore preventing further injury, deformity, or amputation in populations that are often unable to afford quality healthcare. Development of Assessment and Screening Tool to Assist with Prevention and Identification of Charcot Foot in Type 2 Diabetics by Louise Wade MSN, RN MS, West Texas AM Dr. Stoerm Anderson for his constant support and encouragement throughout the project and for being a positive role model in my life; Dr. Deborah Lewis for her support and suggestions for a successful project completion and finally, Dr. Sandra Cadena as serving as the URR on this project and providing positive comments and encouragement. This entire journey would not have been possible without the encouragement and support of each of these people and I am eternally grateful.

Highlights

The DNP project is intended to improve patient care with the use of an assessment and screening tool and algorithm to aid in early identification of Charcot foot in the type 2 diabetic patient populations
The American Diabetes Association reports that 60–70% of people with diabetes suffer from peripheral nerve damage, which can progress to Charcot foot and an estimated 0.5% of these patients will advance to Charcot
The assessment and screening tool is an excellent guide to support practitioners in the evaluation of high risk patients such as diabetics suffering from peripheral neuropathy

Summary

Introduction

The DNP project is intended to improve patient care with the use of an assessment and screening tool and algorithm to aid in early identification of Charcot foot in the type 2 diabetic patient populations. Peripheral neuropathy, or peripheral nerve damage, causes significant issues such as non healing wounds, major infections, amputations, and Charcot neuropathic osteoarthropathy (CN), commonly referred to as Charcot foot, which involves the soft tissue and bones of the foot and ankle and leads to permanent deformities. This may transpire if the bones in the feet suffer fractures and the foot becomes misaligned. Studies have shown men and women are affected and typically in their 5th and 6th decades of life and having had diabetes for at least 10 years or more [18]

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