Graduate Degree Type
College of Nursing
Dr. Joy Turner Washburn
Dr. Marie VanderKooi
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.
Kamp, David H., "Improving Provider Adherence to ADA Clinical Practice Guidelines: A QI Project in a Patient Centered Medical Home" (2022). Culminating Experience Projects. 136.
Available for download on Sunday, April 27, 2025