Date of Award

Fall 12-1-2020

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Sarah M. I. Cartwright, DNP, MSN-PH, BAM, RN-BC, CAPA, FASPAN

Second Advisor

Tawana Tucker, DNP, MPH, RN


Practice Problem: Patients with type 2 diabetes mellitus (T2DM) are at an increased risk of complications including foot ulcerations (Harris-Hayes et al., 2020). Preventive care is essential for the early detection of foot ulcers but despite the advantages of preventive screening, a limited number of primary care providers perform annual foot exams (Williams et al., 2018).

PICOT: The clinical question that guided this project was, “In adult patients with T2DM receiving care in a primary care setting, will the implementation of an electronic clinical reminder alert (ECR) increase provider adherence to performing an annual diabetic foot exam and risk assessment, compared to adherence rate pre alert implementation, in 30 days?”

Evidence: Evidence indicates that ECR alerts to remind providers to perform foot exams improve provider adherence to perform annual foot exams.

Intervention: An ECR alert was implemented to remind providers to perform an annual diabetic foot exam to increase provide adherence.

Outcome: Twenty-three patients had a completion rate of 46% for their annual diabetic foot exam pre intervention implementation and 45 patients had a completion rate of 56.25% post intervention implementation. There was no statistical significance noted but an increase in provider adherence in performing foot exams, which suggests clinically significant outcomes.

Conclusion: Annual foot exams and an ECR alert to remind providers to perform foot exams on people with diabetes can help improve health outcomes in diabetic patients.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

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This work is licensed under a Creative Commons Attribution 4.0 License.