Early Identification and Referral of Patients With Diabetic Foot Complications in the Emergency Department.

Prolonged length of stay (LOS) in the emergency department (ED) and lack of post-ED follow-up pose a risk of worsening infection and amputation among patients with diabetic foot complications.Excessive ED LOS posed a risk of delayed foot care, and triage providers underutilized post-ED telehealth referrals.A graphic icon on the ED dashboard, nurse-initiated order set, and staff education were implemented.A pre-/postimplementation design was used. Outcomes included usage of the graphic icon and order set, ED LOS, and telehealth referrals.Use of the graphic icon and order sets significantly increased ( P < .001). The rate of telehealth referrals upon discharge also increased but was not significant ( P = .086). Interestingly, LOS increased after the intervention.Using the graphic icon and order set can streamline patient referral to telehealth care. Various factors lead to an extended LOS.

Duke Scholars

Author Eleanor Stevenson School of Nursing