02/03/2015
This is what to expect on your first nursing foot care visit
Consent
Your Foot Care Nurse should follow the HCCA (Health Care Consent Act) that requires consent for any treatment. The consent should include: the nature of treatment, expected benefits, material risks and side effects, alternative courses of action, and consequences of not having treatment. Treatment fees are often stated on the consent form. Any additional costs for products or services are discussed with the client during the visit.
Foot Care nurses in independent practice charge a fee directly to the client for the treatment they perform. The client can then seek to obtain a reimbursement of those fees through their employer’s insurance plan, private health care plan or Veteran’s Affairs.
Health History
Your Foot Care Nurse will complete a health history. This incorporates, your chief concerns and expectations of foot care, which includes relevant current, past, social & family history. This assists the nurse to identify risk factors that may be relevant to the outcome of the treatment. Knowledge of previous foot care treatments and/or experience information assists with what has worked or not worked in the past. You should bring a current list of prescriptions, including over-the-counter medications. It is always a great idea to take the actual bottles on first visit or have them available if having a home visit.
Physical Assessment
Your Foot Care Nurse will undertake a physical examination that will include: condition of skin and nails, range of motion, bony prominences, circulation, and sensation. The nurse will want to assess your socks, shoes and gait. It is a good idea to wear, or bring the shoes you use most of the time for a better assessment.
Documentation and Privacy
Your Foot Care Nurse is required to keep your client file confidential, current, complete and secure. Your personal information may be shared with other health team members (e.g. physician). A client has the right to view that which is documented about them and withhold or withdraw consent to the sharing of his/her personal health information at any time.
Plan of Care
Using a nursing diagnosis, (APIE – assess, plan, implement, evaluate), your Foot Care Nurse will create a plan of care with your cooperation. This may include ongoing treatments booked in monthly or 6 to 8 week intervals, client/caregiver teaching, and added complimentary therapies or products. The plan of care may include referring you to a physician, chiropodist/podiatrist, shoe specialist (pedorthist), massage or physical therapist, a diabetic nurse educator/clinic, or wound specialist
Sterilization, Infection Prevention and Control
Your Foot Care Nurse must adhere to strict safety rules pertaining to their equipment use. Tools must be sterilized, preferably autoclaved and pouched prior to use for each client. Hands must be washed before and after any treatment even when gloves are used. All non-reusable items must be discarded after each client. Personal protective equipment must be used to protect the client and the nurse. All Foot care equipment and treatment areas must be disinfected between each client to reduce cross-contamination. It is highly recommended that the nurse review and record her/his reprocessing policies and procedures on an on-going basis to comply with disinfection and sterilization processes.
Disinfection processes should follow the principles of infection prevention as set out by the Public health Agency of Canada. Each province has a standard to follow (e.g., Public health Ontario/ PIDAC “Best Practice for Cleaning, Disinfection and Sterilization of Medical Equipment/Devices”, 3rd edition, and CSA standards). If your provider is qualified to give foot care treatments, don’t be afraid to ask for any of the above information including proof of memberships and/or certificates.
