Foot care training

I'm in Canada. Just to let you know, there is a national push to have all foot care standardized across the country. Part of this would include how to sterilize ie: only by autoclave.

Here in the States routine foot care is considered a "clean" procedure. we use benz-all to disinfect instruments, H2O2, alcohol, gloves, masks, individual emoryboards, sanding disks for the dremel for sanding of thick nails, callouses, etc, cotton balls, a 'probe' only to check edges of nails, and we give a foot massage. Items are discarded for each client, and dremel and instruments cleaned between each client. We each see approx 12-14 clients in an average clinic day. Our clinic visits are $28 for 1/2 hour and our home visits are $45 lasting 45-60 mins. All private pay as routine foot care is not covered by insurance and Medicare. We do not do diabetics or anyone with severe vascular disease as they are referred to a podiatrist, or anyone with infected skin/nail areas. Our company has been in business over 32 years and employs RN's only.
currently i am concerned about the use of proper masks for the nurses protection when sanding skin and nails and health risks involved in using Benz-all. I would like to know how other foot nurses deal with these issues. Does anyone have a suggestion for a mask? (sometimes we are working in very close quarters with 2-6 other nurses all sanding at various times and i am not sure we are adequately protected) And any other suggestions for a good all around disinfectant?

just a quick aside...by "here in the States" i can only say for my area, which is Mass. I do not propose to know the protocol of other States or Canada.

Some thoughts on foot care being a "clean" procedure. If instruments are not being sterilized, how are you protecting the public from fungal or other bacterial infections? What if you accidentally nicked the tissue, this does happen, you have now compromised the integrity of the skin and have introduced potential and probable pathogens due to the the lack of sterilization. Sanding disks are for woodworking and will produce larger dust particles. We are professionals and as such should be using instruments and products in the industry. Using podiatry burs will decrease the size of particles. This now brings me to protection from nail dust. In my practice most of my elderly clients have thickened and usually some sort of fungal nail(s). The only way to try to protect yourself and your client from inhaling very nasty fungal dust is with a dust extractor. Most nurses do not wish to spend the amount of money on this piece of equipment but you must weigh the health factors. Next.... masks, no less than a N95 should be used. You will have to do some research about this as N95's do come in many models and protection. CDC and NOSH approved are the only ones that should be considered.

Hi All,
I hope this clarifies some issues/questions that have been posted recently. Foot care is considered a clean procedure but that does not mean that sterilzation of tools between clients is not essential, especially due to the potential for injury and infection. The simplest product (and safest) for cold sterilization is accelerated hydrogen peroxide. The brand I use is the Accel CS20 by Virox. There are other brand names available (I am in Canada but I do know there is soemthing in the US). For a mask, I use an N95 as it is the best protection available. Whatever products you use, it is imperative that you read the manufacturers instructions and MSDS documents - not only about using the product but also about disposal of it. Pricing will vary depending on how you set up your business. Start with a base salary (what you want to earn per hour or person) and then add all your expenses. That should give you a ball-park figure. Don't forget things like travel time. Having solid policies and procedures/protocols in place when you set up your business/practice is critical. The first few can be tough but then they get easier - I promise.
A word of advice: Always practice to the highest standard! It is the best for you and your clients and it is probably only a matter of time before it becomes the minimum standard.
For the nurses in Vancouver - good luck with your conference. Link up with Foot Care Canada and other resources (such as those that host conferences elsewhere in Canada).
I would be interested in the Alliance if someone wants to PM me