Development of Assessment and Screening Tool to Assist with Prevention and Identification of Charcot Foot in Type 2 Diabetics

Abstract

According to the World Health Organization, up to 50% of type 2 diabetic patients develop neuropathy, which may cause major infections, amputation, and Charcot foot due to impaired sensation. Early recognition and care is essential for treatment of Charcot foot and prevention of further injury. Due to the complexity of this potentially life threatening complication, assessment is challenging, especially when practitioners who treat adult diabetic patients may not be familiar with Charcot foot. The purpose of this scholarly project was to develop an assessment, screening tool, and algorithm for detecting Charcot foot; an additional goal was to develop practice guidelines for practitioners to assist in the early recognition, treatment, and referral of adult diabetic patients at risk for Charcot foot. Lippitt's theory of change was used to guide the project. An interdisciplinary team of stakeholders was assembled to guide development of the tool, algorithm, and practice guidelines. Products were developed in accordance with evidence in current peer-reviewed literature and American Diabetes Association recommendations for Charcot foot diagnosis, treatment, and referral. Content was validated using a scale content validation instrument process to obtain input from experts in the care of Charcot foot. An implementation plan was developed to guide introduction of the products into practice, and an evaluation plan created to determine the extent to which intermediate term outcomes are met using these products. The project may contribute to social change by identifying patients at risk for Charcot foot prior to the onset of the complication, therefore preventing further injury, deformity, or amputation in populations that are often unable to afford quality healthcare.