Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

McKay, Anne

Second Advisor

Rinker, Donna

Academic Year



Background: Diabetic retinopathy (DR) affects millions of people worldwide and is a main cause of preventable blindness. Experts recommend annual retinal screenings on all diabetic patients. Studies show continuing trends of non-adherence, as well as significant barriers to screenings. Recommendations to overcome barriers and methods to improve adherence among diabetics are topics of interest among healthcare providers. The purpose of this project was to increase annual retinal screening adherence among adult diabetics at a privately owned primary care practice in the rural Midwest.

Methods: Staff and 59 patients, chosen through convenience sampling were involved. Pre- and post- implementation surveys were administered to staff to assess knowledge, practice, and attitude regarding DR screening. Education and training were provided to staff to reinforce main concepts of DR and use of office owned tele-retinal imaging technology. Education was posted for patients on the waiting room whiteboard, and educational flyers were provided to patients upon check-in. Staff was encouraged to provide education to each participant upon rooming. Retinal imaging technology was used by staff to complete in- office exams for patients who met inclusion criteria. Uptake of retinal exams was compared to the pre-implementation office adherence retinal exam rate from the prior year.

Results: The results were statistically insignificant (p = .248), however there was a proportional increase in patients who received retinal exams during implementation (pre- implementation adherence = 42%, implementation adherence = 48%).

Conclusions: Staff reported an increase in knowledge and confidence in usability in pre- existing tele-retinal imaging technology. A small yet clinically significant increase in adherence to retinal exams among diabetics was noted during implementation. Knowledge gained could help to guide future similar interventions.