Open Forum

Hi All!

Our podiatrists are overwhelmed with appointments for annual comprehensive foot exams and are booked out months in advance. As a solve, we are looking at expanding this services to being offered by advanced practice providers (APP). The initial/annual visits will be with an APP in family practice. This will benefit the patients in that there will be increased access to comprehensive diabetes foot exam (with nail trimming) and a decrease in financial burden (primary copay vs specialty copay) and improved patient outcomes as a result. The APP will refer patients for management to podiatry based on clinical judgement and complexities. We will have 1 FNP piloting this project. My questions to you all are:

• Have any of you had your advanced practice providers perform this visit type?
• Is the comprehensive diabetes foot exam included in all wellness/physical visits? If so, do your providers do nail trimming?
• Where do you send your patients, with no deformities/complications such as severe onychomycosis, to have their nails trimmed?
• Have you heard of nail salons being certified in working with patients who have diabetes?

Any feedback is appreciated.

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Roxanne Flores
Population Health & Clinical Quality Nurse Manager
Austin Regional Clinic
Pflugerville TX
(512)563-6749
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Roxanne. When podiatry services were pulled from our clinic, I got certified in foot / nail care through WOCN and provided the services as an RN. I was able to do a comprehensive diabetic foot exam and trim nails with severe onychomycosis. It is definitely a service that is lacking in primary care and would help unburden podiatry if more nurses were able to perform these duties.

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Larissa Hawkins BSN RN CFCN
Dept of Veteran Affairs
Las Animas CO
(719)469-9998
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Original Message:
Sent: 09-01-2022 14:13
From: Roxanne Flores
Subject: Comprehensive Diabetes Foot Exam Visits

Hi All!

Our podiatrists are overwhelmed with appointments for annual comprehensive foot exams and are booked out months in advance. As a solve, we are looking at expanding this services to being offered by advanced practice providers (APP). The initial/annual visits will be with an APP in family practice. This will benefit the patients in that there will be increased access to comprehensive diabetes foot exam (with nail trimming) and a decrease in financial burden (primary copay vs specialty copay) and improved patient outcomes as a result. The APP will refer patients for management to podiatry based on clinical judgement and complexities. We will have 1 FNP piloting this project. My questions to you all are:

• Have any of you had your advanced practice providers perform this visit type?
• Is the comprehensive diabetes foot exam included in all wellness/physical visits? If so, do your providers do nail trimming?
• Where do you send your patients, with no deformities/complications such as severe onychomycosis, to have their nails trimmed?
• Have you heard of nail salons being certified in working with patients who have diabetes?

Any feedback is appreciated.

------------------------------
Roxanne Flores
Population Health & Clinical Quality Nurse Manager
Austin Regional Clinic
Pflugerville TX
(512)563-6749
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