Date of Award

Spring 5-2014

Degree Type

Doctoral Nursing Capstone Project

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Dr. Katherine Nugent

Committee Chair Department

Nursing

Committee Member 2

Dr. Patsy Anderson

Committee Member 2 Department

Nursing

Abstract

Diabetes is one of the most frequently diagnosed metabolic disorders and is currently at pandemic magnitude. Approximately 1.4 million adults are diagnosed with diabetes each year. According to the American Diabetes Association (2011), the numbers of diagnoses will more than double by 2030. Because of the high prevalence of diabetes, the perceptions of risk factors and healthy behaviors are important. A good understanding of written and verbal healthcare instructions, healthcare accessibility, and socio-economic status have a direct effect on patient health outcomes and the overall health of the population (Jovic-Vranes, Bjegovic-Marinkovic & Marinkovic, 2009).

Diabetic foot complications are common concerns in diabetic disease management. The management of diabetic foot ulcers poses a challenge to the medical and nursing staff of a wound care center in a rural Mississippi Delta community. Currently, there is a lack of consistency in the education provided to diabetic patients regarding their foot health. This lack of consistency substantiated the need to empower patients with the knowledge necessary to prevent diabetic foot ulcers. Frustrations with the fragmented education provided led to high rates of failed attempts in the prevention of diabetic foot ulcers.

Because of reimbursement constraints from the Centers for Medicare and Medicaid Services (CMS) and private insurance companies, most patients with diabetic foot ulcers are not eligible for structured education. Since structured diabetic education is not covered, beneficiaries are also not eligible for the two-year follow-up course. As a result, the number of foot ulcers and subsequent lower limb amputations continued to increase. The goal of this project was to evaluate the effectiveness of an evidence-based diabetic foot education provided to diabetic patients in a rural wound care clinic. When evidence-based foot education was provided, the participants’ knowledge of basic foot care increased.

This capstone project was based upon the CIPP Model of Evaluation. Qualitative and quantitative data was analyzed using descriptive statistics and frequency distribution. The qualitative themes were used to evaluate the effectiveness of the program and to capture participants’ perceptions of their experiences. Findings from this project proved the effectiveness of providing basic foot care instructions as a pedagogical method of increasing patients’ knowledge of preventing foot ulcer formation.

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