Background: Type 2 diabetes (T2D) is a global epidemic impating adults on every continent. Most type 2 diabetic adults worldwide live in middle-class, lower-class, or poverty income levels. In America, T2D rates are rising steadily, along with medical costs and the burden on the community. Idaho faces the same prognosis if awareness does not change. T2D and related complications are among the few diseases that can be reversed wtih lifestyle changes. A more severe complication is a lower limb amputation due to a non-healing foot ulcer. Individuals with ill-managed T2D and a lower limb amputation have a poor prognosis and will die early from poor care. Primary care providers play a vital role in preventing foot ulcers by improving their standard of care for all at-risk individuals. A rural clinic in Idaho Falls, ID, served mostly middle-class to poverty-level individuals and was chosen as the project site for its potential to impact diabetic lives, raise the standard of care, and decrease disease-related hospitalizations and amputation rates. EBP Framework: In application, Lewin’s Change Theory implemented three phases, unfreezing, freezing/changing, and refreezing, as a guided theory for this project. Iowa’s Revised Model for Evidence-Based Practice was used as the framework to pilot this project at every step of the process. These strategies serve as the foundation for this quality improvement project. Methods: The objective of this project was to bring awareness to the primary care clinic on the risks of diabetes through an in-service, to improve charting and screening habits, and to open dialogue between providers and patients regarding the risks of developing foot ulcers, and then collaborate with other healthcare specialists. The evaluation was determined by comparing provider charts, pre, and post-in-service, for a total of ninety days. Findings/Results: The project findings proposed that many diabetic patients visit the clinic for conditions unrelated to diabetic complications. Approximately three in 15 adults who came to the clinic daily were diabetic or prediabetic. Less than one patient addressed diabetic concerns as their chief complaint among all providers. This project’s goal was to address diabetic risks for all patients at risk and to prevent foot ulcers from developing through evidence-based science to manange the condition. Conclusion/Recommendations: Implementing new charting templates to assess the diabetic foot and score the patient against the risk stratification table suggested that more tremendous efforts are needed to improve the standard of care for at-risk diabetic patients. These template were a guide for inviting open diabetic dialogue and a prompt to collaborate with other healthcare teams to prevent foot ulcerations. Outcomes from this project suggest that providers should include foot assessments or dialogue in every exam for at-risk patients and include a thorough foot assessment as the standard of care for related return appointments to decrease foot ulceration rates.
