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The aim of this study was to examine the impact of introducing the Registered Nurses’ Association of Ontario Best Practice Guideline (BPG), Assessment and management of foot ulcers for people with diabetes (2005), on foot ulcer incidence, recurrence, and amputation rate in adult diabetic clients who are undergoing chronic hemodialysis treatments. Fifty-seven individuals from three hemodialysis units participated in the study. Data were collected at three points in time over a 15-month period. A significant reduction in the number of wounds was noted (p<0.05) from time one to time three, and the grade of wounds (p<0.01). However, five new amputations were reported. Although implementation of the BPG showed a positive patient outcome, further research needs to be conducted with a larger sample size.