Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Joy Turner Washburn

Second Advisor

Dr. Marie VanderKooi

Academic Year



Background and purpose: Diabetes is the leading cause of kidney failure, lower limb amputations, and adult blindness. The American Diabetes Association recommends timely screenings to reduce complications. Flowsheets facilitate improved outcomes. The project implemented an electronic flowsheet to promote staff adherence to select screenings.

Methods: Screenings included foot exam, eye exam, glycohemoglobin, microalbumin creatinine ratio, lipid profile, and anti-hypertensive medication. Staff viewed the flowsheet to determine screening eligibility per ADA guidelines. Quantitative and qualitative data analyzed.

Results: Quantitative results: 40% improvement among medical assistants (MAs) completing foot exams and 75.53% improvement among providers ordering eye exams. No statistical significance among remaining measures. Qualitative results: staff use of flowsheet was positive. Flowsheet deemed a simplified organizational tool centralizing screenings in the EHR to track results by date and display trends.

Conclusions: Staff use of flowsheet suggests organizational gaps in diabetic management as evidenced by statistically significant findings among foot and eye exams. Findings support improvement in patient health outcomes. Flowsheet use may improve care among other diabetic screenings; however, its impact must be studied further.

Implications: Flowsheet use centralizes resulted key diabetic screenings by date eliminating needless searching and fostering staff efficiency. Flowsheets assist staff with timely completion of diabetic screenings leading to improved patient health outcomes.

Keywords: diabetes, management, flow sheet, primary care, management measures, management tools, and clinical decision support.

Available for download on Sunday, April 27, 2025

Included in

Nursing Commons