Preventive Nail Care Among Diabetic Patients: A Quality Improvement Initiative.

PURPOSE: The purpose of this quality improvement initiative was to increase adherence to follow-up appointments in patients with diabetes mellitus for prevention of diabetic foot ulcers. PARTICIPANTS AND SETTING: The sample comprised 33 adults with diabetes mellitus being cared for at an outpatient wound care clinic affiliated with a large metropolitan hospital in the state of Mississippi, located in the Southern United States. APPROACH: This quality improvement approach used the Plan-Do-Study-Act method. Educational flyers and verbal instruction were provided to enhance adherence to preventive nail care and follow-up appointments. The goal for this quality improvement initiative was to increase adherence with preventive nail care and follow-up care. OUTCOMES: Participants were provided with educational flyers and verbal instruction that emphasized the importance of follow-up clinic appointments, which promoted increased attendance at follow-up appointments. The proportion of patients who did not attend follow-up appointments fell from 9.2% prior to the intervention to 5.8% after its introduction. IMPLICATIONS FOR PRACTICE: This quality improvement initiative positively impacted practice at a local wound care clinic in Mississippi resulting in a clinically relevant reduction in no-show follow-up visits when compared to the previous year.

Maintaining placement of temporary enteral feeding tubes in adults: a critical appraisal of the evidence.

Maintaining placement of temporary enteral feeding tubes requires ongoing bedside nursing assessment. Tube placement verification is essential to detect and minimize adverse effects. A critical appraisal of current evidence and best practice recommendations regarding temporary feeding tubes is provided.