Infection prevention and control: Foot health and Hygiene in Aged and Residential care Presented by Keshia Bolton (Podiatrist at Ballarat district Nursing and Health care)
Contents Section 01 Section 02 Section 03 Section 04 Section 05 Aims Foot conditions you may encounter in your personal care role Other presentations you may encounter What you can do to help in your daily care Remove risks
Aims: -To understand what you are looking at -To know what you can do to help -To know when to seek the advice of a health professional
Foot conditions you may encounter in your personal care role: Common: -Moisture in inter-digital spaces (sometimes with whiteness of skin) -Clawed digits -Very fragile skin, that is prone to tearing or injury -Areas of hard skin -Cold purple-pink colour of feet -Red spots and scaling of the skin -Chill Blains -Swelling in the ankles and/or feet -Unusual nail growth
Inter-digital maceration -Too much moisture -Digits close together -Feet sweat in shoes
Tinea Pedis -A fungal infection of the foot - Red spots - Peeling skin - White moist skin between toes
Onychomycosis: - A fungal nail infecton
It s Good to detect: -Small areas of hard skin: Corns Other presentations you may encounter: -Small white/yellow/brown crusted lesions on the tops of feet and legs: It looks a bit like flecks of dried mud. -Chill Blains -Sores surrounded by callus/ Ulcers -A yeasty/mouldy smell to the feet -Swelling in one foot or a certain area of a foot that includes, Heat, redness, and may or may not include pain. -Shiny red appearance of legs, one or both, with legs warmer than usual to touch, and uncomfortable for client. -Any wound on the foot -Gout -Reduced nerve sensation
Cellulitis
Solar Keratosis Gout
Ingrown toe nail
What you can do to help in your daily care: Showering and after 1)Thoroughly clean and dry creases between and under toes. (Try Metho or Tea tree) -This prevents: -Build up of dead skin -Wet skin that doesn t dry and causes skin break down -Bacterial of Fungal infections developing. 2) Callus on feet can be reduced with a pumas stone. -this reduces build up which can cause injury to underlying skin. 3) Apply moisturiser to feet (Avoid between toes) -This helps prevent cracking of dry skin. 4) Regularly check the condition of the skin and nails of the person s feet and lower legs
What you can do to help: Dressing Socks: -Ensure they are not too tight, causing impressions in the skin. -This can cut off circulation. -If feet are very cold to touch (white/purple/pink): -Use warm woollen socks and encourage client to wear thermal leggings, especially if they cannot move much to generate body heat. - With tight socks, try a nick if client permits it
Swelling in ankles and feet Sock and shoes leave impressions
Chillblaines
Ishchemia leading to gangrene
Dressing... Shoes: - Ensure they do not cut off circulation, rub, indent, chafe the skin, or cause the client to trip over due to looseness. You may need to assist in buying appropriate shoes. -Check inside the shoes before putting them on: They may contain stones or objects that could break the skin. - Check the shoe is not too tight! -Ill fitting shoes may cause: -Rubbing on skin: - Corns and callus -Ulcers -Too tight at Forefoot: - Digital deformities - Corns, callus and ulcers
Corn
Shoes that are too tight can contribute
Tight fitting shoes with digital deformations Can cause corns and wounds to develop
Diabetic foot ulcer Diabetic complications Combined with poor fitting shoes
Swelling around edges of shoe
Alternative options to tight fitting shoes Adjustable Stretchy top cover
Shoes continued... Beware of the swelling/swollen foot! - Feet can swell with standing or sitting due to gravity -The shoe may fit in the morning, but is cutting into the skin by mid day. -Laces or straps may need to be readjusted -Alternatively, shoes with stretchy uppers or size modification straps along the entire upper are available.
What you can do to help: Remove Risks Some people may suffer from impaired perception: -Poor balance, poor vision, lost nerve sensation in the feet -Ensure rug edges are not turned up -Remove objects from floor -Check mobility aids are not contributing to injury (Often people can kick their walking frames, harming the feet)
...Contact a podiatrist If you see something that really concerns you or you client:.....contact your local podiatrist
:?Questions?