What Are COVID Toes? A Case Study.

BACKGROUND: COVID-19 symptoms mimic many other common conditions, making it difficult to identify patients infected with COVID-19. Adult patients may exhibit what is called "COVID toes" later in their course of illness. Noteworthy is that COVID toes may be the only symptom in otherwise asymptomatic young adults and children. CASE: We present experience with an adult female patient residing in the United States with presumed COVID-19 infection who was self-isolating with illness not severe enough to require hospitalization. COVID toes were one symptom experienced as a part of her illness. Because COVID toes are usually seen in the recovery phase of COVID-19, and often in patients with less severe cases, many providers are unfamiliar with this new symptom. CONCLUSION: Familiarity with COVID toes will help foot care providers to identify patients who may not have been diagnosed with COVID-19 but could still be infectious and need to be isolated. COVID toe signs may be subtle and often mimic other conditions such as chilblains/pernio, thus a thorough history and physical examination are required.

Expanding a Foot Care Education Program for Nurses: A Quality Improvement Survey.

Faculty of a foot care continuing education program in the Midwest sought to determine current practice and interest in expanding the current program, both didactic and clinical, to meet expanded requirements in certification criteria. An electronic e-mail survey with both quantitative and qualitative questions was developed and sent to 445 past participants who completed the Foot and Nail Care: Education for Nurses Program hosted by the University of Wisconsin-Eau Claire Continuing Education over the past 5 years. There were 99 responses for a response rate of 22%. We asked several questions about clinical practice specific to the use of equipment, roles and responsibilities, and practice sites. Most participants used a mechanical rotary file for debriding toenails in their practices, with almost half having obtained a more advanced rotary file the longer they practiced. Most participants practiced in a variety of roles and settings including part of their paid employment, an independent business (full- or part-time), or volunteer. Less than half of respondents have become certified in the specialty. Those who have sought certification have chosen either the Wound Ostomy Continence Nursing Certification Board's Certified Foot Care Nurse or the American Foot Care Nurses Association's Certified Foot Care Specialist (CFCS). Sufficient interest (77%; n = 75) was expressed to expand the course to meet the requirements of certification, specifically for clinical hours. Based on the results of this survey, we concluded there is value in offering the program with several modules where participants could complete an introductory course and have the option to participate in continued education should they decide to learn more, seek certification, or need continuing education for recertification.

Onychomycosis: Diagnosis, Treatment, and Prevention.

Toenail disorders account for the majority of foot complaints for which adults seek medical care. Onychomycosis, a fungal nail infection, is the most prevalent. Dermatophytes are responsible for the majority of nail infections and cause varying degrees of nail deformities. While several treatment strategies are available, no one approach (topical, systemic, or mechanical) is highly curative. This article reviews causes, diagnosis, and treatment options for onychomycosis and provides patient education tips to prevent and limit the spread of the disease.

Pad weighing for reduction of indwelling urinary use and catheter-associated urinary tract infection: a quality improvement project.

Catheter-associated urinary tract infections pose a significant risk to hospitalized patients. Measuring accurate urinary output is a common reason for indwelling catheterizations in acutely ill patients. The risk of catheter-associated infections may be eliminated while maintaining ability to measure urinary output of incontinent patients through the use of a highly absorbent pad and weighing postincontinence. The dry pad weight is subtracted from the wet pad weight and the resulting difference (expressed in grams) equals the volume of urine leaked into the pad in milliliters. We found that using this system of improved measurement of urine output when compared to documenting the number of incontinent episodes while allowing removal of indwelling urethral catheters as soon as possible.