Competency Assessment for Diabetic Foot Exam
Competency assessment for diabetic foot exam This form can be completed by a peer, mentor or trainer. Shadow the medical assistant or nurse who is rooming the patient who needs the exam and observe that all elements of the examination are satisfactorily completed. Keep in mind that this assessment can be used for training purposes and can be modified to meet the needs of your practiceName of nurse being evaluated:Name of evaluator:Date of evaluation:What is your primary purpose of your visit? If you have a new complaint, please describe the symptom and indicate how long it has been present, when it is better or worse and any other information that might be helpful to the physician and/or petency requirementNot completedNeeds practiceSatisfactoryDescribes foot examination clearly to the patient Accurately assesses:Footwear and socksSkin integrityFoot deformityFoot pulse palpationCorrectly uses 10g monofilament Educates patient on proper foot care Clearly records findings or reports to the physician Other: Comments:AMA Practice transformation series: expanded rooming and discharge protocols. 2014. ................
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