Discussion about foot care

nurse_training_in_foot_care

Are You Salary Capped?

Many times, nurses are salary capped at their level and the only way to increase their pay is to pick up a new specialty. Prof-Ed offers unique specialty training towards certification in routine foot care. 

There’s a growing demand for nurses (and all health care providers, in fact!) who can give foot care. Why? Because the population of those needing foot care is growing:

  • The ‘Boomers have passed the threshold of “elderly” (past age 65) and are not as nimble in their own foot care.
  • The number of Americans with chronic illness is increasing – per the CDC, more than half of those over 65 have at least one chronic illness and their foot care must be appropriate for their health considerations.
  • Our level of colonization for pathogens is higher than ever. With “super bugs” resistant to traditional treatments, infection control must be impeccable….beyond what is typical in a salon in the mall.

This creates a perfect opportunity for nurses who can provide this vital care for their patients. However, most facilities cannot allow nurses to address the feet of their patients unless they are trained and certified in proper routine foot care (RFC) protocols.

What is RFC? Per Medicare it is comprised of the following tasks:  trimming and thinning down thickened toe nails, reducing excess callus (debridement) and applying therapeutic moisture. These tasks are will within the scope of practice for nurses who are properly trained.

Without a doubt, you, as a nurse, have seen examples of patients who really needed RFC, but were unable to assist them. This could be changed, and the best part is that you could pick up another specialization….and perhaps a raise!

LPN/LVNs read about foot care training here: Clinical Practices in Foot Care for LPNs

RNs read here: Best Practices in Foot Care for RNs

 

foot care prof-ed

Foot Care for Baby Boomers

Professional Education, LLC, announces a new online offering: Strategies for Entrepreneurial Nurses

After specialized foot care training, nurses can set up boutique practices to tend to the growing demographic of elderly and chronically ill patients who need safe, healthy foot care.
prof-ed trainingThe U.S. Dept. of Health and Human Services (HHS) announced in April, 2018, in the final 2019 Notice of Benefit and Payment Parameters the rules will change requiring certain health plans to cover “essential health benefits” (EHBs).  These changes mean states and insurance providers can redefine what coverage will be allowed for those living with diagnosed pre-existing conditions, including diabetes. It is likely foot care benefits will be further reduced for those living with chronic conditions such as diabetes, and these patients will be forced to pay for this important care. As an alternative to high costs in hospitals and medical offices for this care, RNs will be able to meet these needs for routine foot care for the chronically ill in independent boutique foot care businesses as per their state Nurse Practice Guidelines.

To meet this growing demand for foot care, Professional Education announces the creation of a dynamic online 5-module course, Strategies for Entrepreneurial Nurses. This program guides nurses in the steps necessary for setting up boutique nursing care businesses and offers important marketing and business strategies in a track toward success.

The course was written for nurses who have the expertise to provide safe routine foot care for their patients, however, any niche nursing specialty could benefit from this guidance. The Strategies Program solves the problem of “no prior business training” for these new entrepreneurs. It provides them the information they need in setting up a business specializing in foot care, ensuring higher success and efficiency in their practice and smoothing out potential bumps in the road to success.

Time-lines, check lists, equipment lists, and much more are provided to support efficient set up of their businesses. A myriad of considerations for establishing a new business are included along with the necessary business information they were never offered in traditional nursing training. Strategies for Entrepreneurial Nurses is available on the cutting-edge online educational platform at www.Prof-Ed.com.

Professional Education (www.Prof-Ed.com) also has created comprehensive preparatory course, s for both the RN and the LPN/LVN level which meet the qualifications necessary for both the CFCN® and the CFCS® certifications. For further information, see www.prof-ed.com or call 863-273-9134.

FCNs Must Test for PAD

Foot-care-trained nurses are quick to spot troubling symptoms in their patients’ lower limbs and feet

Peripheral artery disease (PAD), sometimes called Peripheral Vascular Disease (PVD), is a disease in which plaque may build up in the arteries outside the heart that carry blood to the head, organs, and limbs. This plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When it builds up in the arteries, the condition is called atherosclerosis. Unless prevented or treated, plaque can narrow the flow of blood in the arteries.

This limits the flow of oxygen to organs and other parts of the body which can ultimately lead to death of a patient. It can happen in any organ but is more often in the legs. (PAD can also be from other causes than atherosclerosis.)

According to the CDC, PAD can be asymptomatic, causing a dangerous situation for sufferers as it can lead to coronary artery disease and cerebrovascular disease, which could lead to a heart attack or stroke. For this reason, patients with risk factors should be tested for PAD to allow early diagnosis of the disease, if it is present.

Risk Factors for PAD are:    

Foot exams reveal symptoms of PAD

 Smoking
 High blood pressure
 Atherosclerosis
 Diabetes
 High cholesterol
 Older than age 60

Foot Care Nurses must be fully educated about this disease. Studies show that about half the cases remain unrecognized, allowing a high risk of ischemic events in the future of these patients. Therefore, if a patient has pain, numbness, aching, or heaviness in the leg muscles (possibly claudication) with exertion which is relieved with rest, it’s time for a complete exam and to test of PAD.

Check for these symptoms:
 Weak or absent pulses in the legs or feet
 Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
 A pale or bluish color to the skin
 A lower temperature in one leg compared to the other leg
 Poor nail growth on the toes and decreased hair growth on the legs
 Erectile dysfunction, especially among men who have diabetes
 Muscle atrophy
 Hair loss and smooth shiny skin

Diagnosis of PAD
In patients with these symptoms, the ankle-brachial index (ABI) is indicated. It’s a simple and quick, non-invasive test that measures the blood pressure in the ankles and compares it with the blood pressure in the arms at rest and after exercise. If the ABI is <0.9, the patient must be immediately referred to a vascular specialist. This physician will prescribe imaging tests such as a Doppler ultrasound, magnetic resonance angiography (MRA), and computed tomographic (CT) angiography. These tests provide additional information in diagnosing PAD.

Conclusion: Foot Care Nurses with knowledge of PAD can save lives through responsible practices. If a patient 1) has symptoms that indicate PAD or 2) has the risk factors for PAD, the FCN must conduct an ABI. This test will determine potentials for the presence of PAD and whether he or she should be referred to a specialist.

September is Pain Awareness Month

Did you know…

Gout is one of the fastest growing arthritic illnesses in the United States.

It is very painful and is difficult to treat. Caused by the imbalance of uric acid in the joints, one of the most affected joints in Gout is the hallux. Foot Care Nurses will see patients who have this form of arthritis. In many cases it can be successfully managed through dietary changes.

FCNs must know the dietary changes that will manage this disease and then educate their gout-suffering patients on these tactics. The most effective dietary change is reducing the amount of uric acid levels; this will reduce the number of attacks.

The Arthritic Foundation has an excellent blog titled “What Role Does Diet Play in Gout Management”

A second great informational blog is titled “Making Smart Meat Choices if you have Gout”

These blogs are written for the consumer but are excellent education for Foot Care Nurses to pass on to their suffering patients.

 

Foot Care with Electric Files

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Foot Care with Electric Files

Foot Care with Electric Files

Electric files can be the most productive and safe way for callus reduction, nail shortening and smoothing.  Includes video demonstration of various techniques you will need to know for using an electric file throughout a foot care service.  The proper use of an electric file can be more comfortable for your clients and ergonomically beneficial to you, as well.

Foot Care with Electric Files

      • Gives background information on the components of electric files
      • Discusses the various bits/burrs and when they are appropriate
      • How to choose a machine and burrs for your practice
      • Demonstrates several necessary techniques you will need to know

This Presentation will teach you higher quality techniques for performing more profitable services.

New Course: Foot Care with Electric Files

Nurses who provide foot care for their patients need electric filing skills.

Tending to your patients requires manual dexterity–and a smart nurse will use all the tools available. Hand-held rotary devices (aka electric files or e-files) are just one of those tools…but they have many benefits.

Benefits of Electric Files

First and most logically, perhaps, is that any time you are reducing the thickness of a thickened nail or taking down excess callus, using a specialized abrasive will be faster. Targeting a specific area with a properly braced abrasive can allow quick, yet comfortable, reduction of excess nail or callus.

New Course Offered: Foot Care with Electric Files

Something you might not have thought of, is that taking down callus or thickened nails can be safer with an electric file. There is the opportunity for injury with any hand-held implement–whether a hand-held file or an electric machine–but it is easier to safely confine the abrasive surface to the desired area if the hand is still, rather than moving back and forth with manual debridement.

Another benefit to an electric file is the longevity of your career. Repetitive movement stress on your shoulder, elbow, wrists, etc. can be reduced greatly by using an electric file.

Electric File Training

Learning to safely use an electric file is first, learning about your machine and the bits or burrs, and secondly, learning a safe way to practice. One of the best things to do is to take a training course that breaks down the machine, its parts and the burrs, and then practice on yourself. You will quickly learn what the “ouch” factor is if you abrade your own callused area too long and heat it up! Professional Education’s course not only teaches you all the moving parts, but it also shows you some practice techniques you can set up for yourself. The videos embedded in the course show a couple of grips to hold the hand piece as well as demonstrate several specific tasks the electric file can help you safely, quickly perform.

Click here to read more about this course.

Summary

Diabetes Requires Specialized Foot Care

It is estimated that up to 25% of all diabetics will develop a diabetic foot ulcer (1)

One of the cruelties of Diabetes Mellitus is that the people who are at most risk are often hurt the worst because they have lost sensation in their extremities. Neuropathy manifests not only with burning/tingling/itching “phantom” pain, but many times with complete loss of sensation. Neuropathy can allow injuries to go unnoticed, and therefore untreated–often times past the point of recovery in the wounded area.

Prevention is the Best Medicine

The best possible scenario for a diabetic is that the skin is never broken or otherwise traumatized. This means safe, careful care of the body, but especially the feet.

Why are the feet any different than any other body part?

Because the sheer distance away from the core means reduced circulation and less oxygen, nutrients and waste removal is happening. Wound management is simply different for the feet than any other area of the body.

In a survey of nursing textbooks, foot care was barely addressed–maybe a few paragraphs–a page or two at the best. Yet nurses are the front-line foot care providers for many patients. They see the patients before the doctor ever walks in the room and are more likely to hear complaints of foot pain. They provide the primary care for many patients–including providing Routine Foot Care.

Routine Foot Care

As defined by Medicare, Routine Foot Care (RFC) includes tasks such as cutting or removalslide pic 2 of corns and calluses, the trimming, cutting, and clipping of nails, or hygienic or other preventive maintenance, including cleaning and soaking the feet. Many times these tasks are performed by nurses, allocating the doctors’ time spent with the patient to more pressing health issues.

RFC may be a very simple task under ordinary circumstances; however, when there is the presence of a chronic illness, especially one which impedes healing, the risks associated with little “nips” or “cuts” during procedures become overwhelming.

RFC by Trained Foot Care Nurses

In many states, nurses working within their scope can perform RFC for their patients, while in others, a specialty certification is required. Once such specialized certification is the Certified Foot Care Nurse® by the WOCNCB. Whether a nurse seeks this certification or not, this specialized training is a must for all nurses who provide foot care as primary care providers. To learn more about foot care training programs, visit www.prof-ed.com

(1)CDC Review Preventing foot ulcers in patients with diabetes Singh N, Armstrong DG, Lipsky BA JAMA. 2005 Jan 12; 293(2):217-28.

 

What do Chronic Illnesses Mean for Your Patients’?

How do these chronic illnesses affect the feet and lower legs of your patients?CIR782 WHO graph

The CDC, World Health Organization and countless others exert a lot of effort estimating the impact of chronic illnesses on today’s world population.  How do these issues affect you and your patients? One direct impact is the care of their feet.

 

Routine Foot Care – is defined by Medicare as the activities of trimming of nails, thinning thickened nails, reducing excess calluses and application of moisture.  These routine acts are often impossible for your patients to perform for themselves….they need your help!

Did you know there are nurses who are trained to safely perform the activities of Routine Foot Care (RFC)…and more!  They are trained to recognize any out-of-normal conditions of the feet and lower legs and make appropriate referrals to physicians when needed. YOU could become one of these nurses.

Often nurses in long term care facilities, home care employment and even floor nurses are the ones responsible for seeing to the feet and nails of their patients. If you are not well-trained and confident in your skills, you might put this type of care off as long as possible…which could be dangerous to a patient. Taking an online course is an excellent introduction to the process of becoming certified in foot care.

Wound Care – is a discipline unto itself. All nurses must be capable of working with wounds, but wounds of the lower extremities have real differences in their healing process. Do you know what is different about wounds of the feet? What should you be aware of when working with a foot ulcer? Are you familiar with the various off-loading therapeutic appliances?  These are topics that are covered in Prof-Ed’s courses.

Neuropathy – is a common side affect of both diabetes and PAD. Did you know not all manifestations of neuropathy are alike? It’s a continuum…from small occasional twinges of sharp pains or “pins and needles” through shooting pains all the way to complete constant burning. And then there’s the loss of sensation…from spots of inability to feel temperature differences to occasional numbness to complete loss feeling of any kind. It’s both too much sensation and not enough sensation.

Do you know the various assessment tools for determining LOPS (Loss of Protective Sensation)?  Helping your patients understand what their neuropathic symptoms mean for their lives is vital.

Foot Care Specialty – is a valuable commodity for your career. The need for this specific skill set is huge…and growing as the “Boomers” are aging. Approximately 25% of Americans have been identified as “Baby Boomers.” This is a huge patient demographic…and they will need help with their feet! Get yourself trained and ready to meet the demand.

 

 

Foot Care Internship Program

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Click here to download the Cover Letter for the Internship Packet

Click here to download the Skill Log

Click here to download the Internship Preceptor’s Manual

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Treatment Videos – Click each link below to view in a new window

We at Prof-Ed do not practice medicine, nor advocate any person practice medicine outside their scope of licensure. These videos were selected from public standard YouTube offerings as examples of procedures you might encounter during your proctored internship.

Ingrown Nail Relief-Black’s File

Plantar Wart Cryotherapy

Acid Treatment of a Plantar Wart

Wart Removal Surgery

Large Plantar Wart Surgery

Scalpel Removal of a Callus

Infected Ingrown Surgery

Extremely Infected Ingrown