Practical Guidelines - Education

Guidelines 

 

 

Education of patient, family and healthcare providers

Education, presented in a structured and organized manner, plays an important role in prevention. The aim is to increase motivation and skills. The patient should be taught how to recognize potential foot problems and what action should be taken.
The educator must demonstrate the skills, e.g. how to cut nails appropriately. Education should be provided in several sessions over time and preferably a mixture of methods should be used. It is essential to evaluate whether the patient has understood the message, is motivated to act and has sufficient self-care skills.

An example of instructions for the high risk patient and family is given below. Furthermore, physicians and other healthcare professionals should receive periodic education to improve the care delivered to high risk individuals.

Fig 3. How to cut nails

 

 

Items which should be covered when instructing the high-risk patient

  • Daily feet inspection, including areas between the toes.
  • If the patient cannot inspect the feet, someone else should do it.
  • Regular washing of feet with careful drying, especially between the toes.
  • Temperature of the water should always be less than 37 O C.
  • Avoidance of barefoot walking in- or outdoors and wearing of shoes without socks.
  • Chemical agents or plasters to remove corns and calluses should not be used.
  • Daily inspection and palpation of the inside of the shoes.
  • If vision is impaired, the patient should not try to treat the feet (e.g. nails)by themselves.
  • Lubricating oils or creams should be used for dry skin, but not between the toes.
  • Daily change of stockings.
  • Wearing of stocking with seams inside out or preferably without any seams at all
  • Cutting nails straight across (See figure 3).
  • Corns and calluses should not be cut by patients, but by a health care provider.
  • The patient must ensure that the feet are examined regularly by a health care provider.
  • The patient should notify the healthcare provider at once if a blister, cut, scratch or sore has developed.