Foot Care

casi, ASN, RN · Jan 17, 2015

I honestly wish that lotion was just apart of AM and PM cares, especially in the winter months. I'm seeing a lot of excoriation to backs and legs from scratching.

bethann27 · Jan 18, 2015

Olive oil or A&D ointment are what seems to work best for the shower schedule because it lasts longer. Inexpensive lotions contain alcohol and can be drying.

bethann27 · Jan 18, 2015

Oops ....A & D

MN newbie · Jan 18, 2015

Is it all the residents or could it be a few that could be combative with cares?

Do the aides have enough time for lotioning every foot?

You seem like you do a great job running your facility, but the statement sounds pretty broad when there can be a lot of reasons why someone doesn't get their lotion.

Could lotioning be scheduled before afternoon naps when the staff might not be as busy as they are in the morning before breakfast?

just a few thoughts.

CapeCodMermaid, RN · Jan 18, 2015

We'd cited for using olive oil on someone. It takes less than 2 minutes to put lotion on someone's feet so I don't think time is the reason...I think they know that know one was paying attention. I can bet when I go in on Monday, people's feet will look better than they did.

ktwlpn, LPN · Jan 18, 2015

some CNA'S are more conscientious then others. Now they know you care, you'll see a difference. The lotion our cna's use as part of our protocol with AM and PM care is just not that great. For people with really funky,scaley feet we will do something strong and thick at HS every night until that clears up (petroleum jelly,A&D,etc).The nurses perform a weekly skin check with the shower,we have had a few who missed DTI's to heels or vascular ulcers between the toes. That's when they should pick this up and get an order for something else. I was known for getting on my hands and knees with a mirror,I left no toe unturned.

Maddie86 · Jan 20, 2015

I went on a foot care rampage when I first became a unit manager after seeing the most disgusting pair of feet in my life the first day on my new unit. I could not believe what I found. I ended up making a shower schedule and witnessed and assisted with each resident's shower the first 3 weeks I took over. My CNAs and nurses were exhausted by the last one, but you better believe they understand the importance of skin and foot care for these residents now! Now, on the floor, things are different. What I did when I worked the floor was take a wipe in between toes on each foot and behind the ear of random residents that were scheduled for a bath on my shift. I did that at the end of the shift to hold the CNAs accountable. If they know you are looking, they will do it the right way. EVERY resident should get some kind of lotion or moisturizer to their skin after their shower/bath/during ADL's daily and even more if needed depending on the resident.

Also, I preach to my CNAs that "we are only as good a unit as our dirtiest feet". This is true. If your CNAs take care of your resident's skin, half your job is done. Nursing can take care of the rest. Think about it...if your CNAs keep them washed, lotioned and from getting discoloration or bruising or any type of skin damage, their job is done. That means that they are transferring properly, they are performing ADLs appropriately, etc. So...just ensure you do the quick, little things that make it clear to your staff that you are paying attention to what is going on!

Meghann

bethann27 · Jan 20, 2015

We'd cited for using olive oil on someone. It takes less than 2 minutes to put lotion on someone's feet so I don't think time is the reason...I think they know that know one was paying attention. I can bet when I go in on Monday, people's feet will look better than they did.

Did you have an order for the olive oil? As long as skin is intact it should be OK with an order.

LaRN · Jan 27, 2015

:dead: I could've written this.

if there is that much dead skin, it usually means they aren't washing the feet very well or at all even. makes you wonder what else they aren't washing. it's a lot of work but you may have to go back to the drawing board and check off all of your cna's on their bathing skills. still a lot less work than dealing with a tag.

CoffeeRTC, BSN, RN · Jan 29, 2015

Here is what I'm finding out....come CNAs don't know how to really wash feet. Sounds stupid, right?

or maybe they don't know the best way to really clean the feet? Some need a good soaking and then get the wash cloth soapy and wash inbetween the toes. Problem is, they might just wipe the top of the feet and not get inbetween toes. Skin builds up and then just flakes off. If they are always getting a quick shower or bed bath, water needs to get on those toes! I also see them not dry them that well either. After they are washed real good, I've showed them to apply lotion or a thicker A&D then put on clean socks.

The no clean socks thing put me thru the roof.....yuck.

morte, LPN, LVN · Jan 29, 2015

Lotions are probably not the best idea. A+D, probably. but you need to be aware that some of the issue Inzo probably a dry fungal infection. Perhaps Inzo, or something of that ilk would work.

and, of course, hydration, hydration, and more hydration.