Implementing the Heikes Screening Tool for Prediabetes and Type 2 Diabetes for Adult Patients in a Rural Primary Care Clinic


Author/Creator ORCID






Doctor of Nursing Practice

Citation of Original Publication



The problem identified showed inconsistencies in screening for prediabetes and type 2 diabetes by primary care providers at a primary care office in rural Maryland. After a complete literature review, a standardized screening process for identifying those at risk for prediabetes and type 2 diabetes was the solution to this problem. The purpose of this project was to standardize a screening process for prediabetes and type 2 diabetes. A standardized screening process was created to assure all patients meeting criteria for the American Diabetes Association (ADA) screening guidelines were screened properly for risk while delivering the standard of care to all patients. The goal was to increase screening by practitioners. This will aid in early diagnosis of the disease, thus leading to a decrease in diabetic related complications. Heikes screening tool was implemented using a standardized process involving an inclusion and exclusion checklist created by the ADA to identify those needing further screening. If a patient met inclusion criteria, a Heikes screening tool was completed. The patient’s risk was then identified from the screening tool and discussed in real time with the patient. Heikes screening tool was evaluated and measured by how many additional patients could be captured for being at risk with the use of a standardized screening process. The Heikes screening tool and process created a more standardized approach to identifying patients at risk for prediabetes and type 2 diabetes. Descriptive and inferential statistics were used to analyze this screening process. There was a final sample of 40 participants using convenience sampling. The screening process was able to identify and screen 22.5% of participants that had not been previously screened as evidenced by a chart review or patient reporting. The data also revealed participants who had a waist circumference of 38.4in or more had a 6.65% higher risk of being in the high-risk category for diabetes development through the Heikes screening tool (p < 0.001).