Foot care training - page 21

I have been interested in starting a foot care service for some time now and after reading posts from LoisJean feel this is something I can do. I would like to start out by receiving some kind of... Read More

  1. by   Ciege911
    Emmory was all power point. I will do some more looking today in regards to updated videos and post what I find here. I would like a simple video to show patients as well as one for teaching staff members.

    Lani, here are the Medicare reimbursement requirements: DM alone does not qualify for reimbursement, must have DM and neuropathy one of the following documented components-nontramatic amputation of the foot, ischemioc component, absent DP or PT pulse, lack of hair, thickened nail, changes in skin pigmentation, skin atrophy, dependent rubor, claudication, temp. changes, edema, parestheias, burning/tingling, mycotic nails, pain in limb, gait abnormality, ankle/foot arthritis or deformities.
  2. by   spadon

    I am a certified foot care nurse. I had a foot care business in Colorado, but have relocated to the Phoenix area. I was wondering if there are any nurses in Arizona who have their own foot care business or work for foot care clinics, as I am interested in getting back into foot care. Thanks for any information.
  3. by   Liveandlearn
    What ever happened to FNANA, Foot Nurse Alliance of North America?

  4. by   lindy_
    Can a bleach solution be used to properly clean instruments between clients?
  5. by   Ciege911
    Hi Lindy, I would refrain from using bleach on your instruments between patients. Bleach may/will cause pitting in stainless steel and void manufactor warranty. (I paid way too much for my instruments to void warranty and ruin them!!!!) Your instruments need to be sterilized between patients, not just disinfected. I use a surgical instrument cleaner and and a disinfectant prior to autoclaving my instruments b/t patients. You can use cold sterilization but the dwell time is often 6+ hours and the cost averages about $25 per gallon with 1 gallon used daily (depending # of clients/instruments). If you have enough instruments you could cold sterilize over night. Unfortunately cold sterilization is expensive and the products typically have a low shelf life once open (10-30 days usually). For best practice I would follow CDC guidelines for cold sterilization, I don't have the exact webdress--but start with and search cold sterilization. I do know Cidex is often used as a cold sterilizer (quick search on McKesson got $100 for a case--product # 387213). Anyway, I hope this helped. Overall I would make every attempt to buy, borrow, or steal an autoclave--it takes 20 minutes and instruments are STERILE and ready to use. Just kidding on the steal part--don't want to hear Ciege911 said I could--ha ha.
  6. by   lindy_
    Thank you so much for your response Ciege. My agency was just awarded the public health nursing contract for our County. One piece of that contract is to continue a popular traveling foot care and toenail cutting clinic. The previous agency used bleach to disinfect between clients and we are in the process of writing our own policies. We will not begin seeing clients until late August. I am going to have to really start researching to see if there is such a thing as a small portable autoclave etc. These clinics are held at congregate meal sites, homeless shelters, churches etc. Does anyone else do similar clinics and what has worked best for you as far as sterilizing instruments? Thanks so much. I love this board!
  7. by   Ciege911
    I got my CFCN training at Emmory in Atlanta and recently took certification test--let me know if you need help with that too. We did a traveling foot clinical at Emmory and they would disinfect instruments on site and then take instruments back to the hospital for sterilization. I know this practice is okay with CDC and should give you coverage in event of problem. Perhaps you can do the same, I would think that public health has a autoclave on site. Congratulations on the grant/contract, I work for IHS under somewhat similar circumstances and must meet certain goals/guidelines for funding. You can also look up IHS best practice guidelines which may help you to develope your PP manual. This should help, because it is all gov guidelines but it does focus on diabetics only.
    Let me klnow if I can help anymore and good luck.
  8. by   footsavvy
    You may just want to have enough complete sets of instruments and burs for the amount of people you will be seeing, and have all instruments sterilized and wrapped individually. If you have funds, this is the simplest way to go... so that you are not spending half your time dealing with cleaning instruments!!
  9. by   footsavvy
    Regarding FNANA... It never really got off the ground. Two nurses from Arizona took over the binder, but did not have time or resources to manage it. I now have the original binder and have been in the same circumstance. I will be meeting with 6 CFCN's at the Baton Rogue LEAP course next month and we will be discussing the organization of some sort of foot care nursing interest group. It will be up to them, as I am pretty swamped with a nonprofit organization that I started... THE PREVENTIVE DIABETIC FOOT CARE ALLIANCE. Maybe someday we will get organized!!!
  10. by   thewowfactor
    i work for a small foot care company in massachusetts and we use Benz All to "clean" instruments between patients. we do routine foot care, no diabetics. private pay. RN's only.
    Benz-All is an efficient germicidal concentrate of benzalkonium chloride with an added anti-rust ingredient. Shown to be effective in the chemical disinfection of instruments and equipment. Once diluted, benz-all is almost odorless, does not have a tendency to stain, and has minimal color change with a change in the pH. Cleaned instruments should be immersed in benz-All for at least 15 minutes for effective disinfection, rinsed with sterile water and dried before use. 10mL bottle mixed with tap, distilled or bottled water makes 1 quart of solution. 40mL bottle makes 1 gallon
  11. by   footcare nurse
    Just wanted to make a comment about the cold sterilization method. If you purchase the product Accel SC20, which is sold in a gallon, all you have to do is pour out enough liquid to cover your instruments and this amount can be used over and over for the next 14 days.
    No need to use a whole gallon. Other liquid sterilants require that an activator be added to the gallon, which then requires that you use that entire gallon.
  12. by   footcare nurse
    I would like to question you about your message.
    Disinfection is not the same as sterilization.
    All instruments must be sterilized for each client, anything else would be poor nursing practice and also place the client at high risk for infection.
  13. by   thewowfactor
    To Footcare Nurse, you said "Just wanted to make a comment about the cold sterilization method. If you purchase the product Accel SC20, which is sold in a gallon, all you have to do is pour out enough liquid to cover your instruments and this amount can be used over and over for the next 14 days.
    No need to use a whole gallon."
    Could you please tell me where this product is available? I cannot find it anywhere on the internet and the RN who owns the business would like more information. Are you in Canada, or US? We have also used a product called Ecotru. Thanks for any assist you can give in finding the cold sterilization product you mentioned.