Outcomes of Nurse Practitioner Driven Limb Preservation Clinic in Northwest Georgia

Introduction: This Northwest Georgia community had a need for diabetic nail care that could not be provided during acute hospitalizations. The need identified the demand for an outpatient service for preventive foot care to be provided for a select population group.  Objective:  It was hypothesized that the number of amputations would decrease among diabetic patients who routinely received preventive foot care, which includes screening, education, and interventions, at a Northwest Georgia nurse practitioner driven foot clinic   Methods:  A randomized retrospective chart review was performed on 292 diabetic patients, who were provided preventive foot care with a mean duration of 29.31 months by nurse practitioners at a Northwest Georgia Foot Clinic.  The average age was 69.26 with 55.8% being male and 22.6% being African American.  In addition, 69.2% were diagnosed with loss of protective sensation (LOPS).  Foot deformities noted included the following:  101 patients had hallux valgus, 164 had hammer toes, 13 had Charcot’s deformity.  Of the population, 44.9% wear therapeutic diabetic footwear.  Results:  Prior to preventive foot care 23 patients had amputations due to diabetic foot ulcers (DFUs).  Collective data revealed no patients suffered an amputation during the treatment plan.  This represents 0% of the treated diabetic patient sample with a standard deviation of 0.00.  Conclusion:  The data reveals a statistical significance in this nurse practitioner driven clinic.  Preventive foot care is having an impact in reducing amputations in this Northwest Georgia community.  Furthermore, this also represents a projected 2.1 million dollar cost avoidance for this Northwest Georgia Community Hospital.