Abstract

Purpose: Diabetic foot complications continue to be one of the most costly, devastating and feared. As 25% of persons living with diabetes may develop foot complications. Therefore, it is most beneficial to screen the feet of diabetics at least annually, to detect early the presence of neuropathy, ischemia and/or foot deformity which can increase risk of ulcers and amputations. The purpose of the study is to evaluate the diabetic foot screening process in the public health setting and document the impact of digitization on improving the number of foot screenings completed and documented. Methods: Consistent screening the diabetic foot has been a challenge and after training numerous groups of nurses and other health care providers to use the Inlow’s 60-second Diabetic Foot Screen for the Assessment and Management of the Diabetic Foot by Wounds Canada the yield was dismal. In 2022, the training process was revised and the screening form was digitized using Google Forms and evaluated for its impact on screening behaviour of health professionals. Results: A 100-fold increase was noted in the number of nurses completing the foot screening and documenting them using Google Forms. This has resulted in early detection of foot complications, referrals to the Podiatry services within the department and improved delivery of diabetic foot care and vascular interventions. Conclusion: Early detection can prevent foot ulceration and related complications. Early treatment can improve the healing of diabetic foot ulcers and reduce the risk for amputation and early mortality. Primary care screening programs for diabetic foot ulcers may include risk assessment, patient education, and referral to more specialized care. Risk stratification considers the presence of neuropathy and or peripheral vascular disease to determine the risk of developing diabetic foot ulcers or amputation. Depending on the level of risk, suitable preventive measures can be undertaken.

Keywords

diabetic foot, diabetic foot screening, diabetic foot complications, risk stratification, inlow’s 60-second diabetic foot screen, Bahamas