Homeless Hope: a voluntary, nurse-led organisation working to educate and support people sleeping rough.

This article describes the development of a nurse-led voluntary organisation that provides basic foot care to the homeless at street level in three Welsh cities. There is a large percentage of street sleepers who choose not to access professional health and care services for various reasons, and many of these individuals have foot health problems, such as sore, painful, swollen feet from continuous walking, calluses, dried skin, blisters that are often de-roofed and trench foot. Through support and education, however, several of these people have been able to take ownership of their identified problems, by building trusting relationships with Homeless Hope nurses. Through collaborative communication with professional services, Homeless Hope nurses provide an informal link between non-engaging rough sleepers and the services in place to help support them.

Nurses' knowledge of foot care in the context of home care: a cross-sectional correlational survey study.

AIMS AND OBJECTIVES: This study aimed to explore nurses' knowledge of foot care and related factors in home care nursing. BACKGROUND: Nurses caring for older people are increasingly confronted with clients who have multiple foot problems and need support with their foot health. The role of nurses in promoting foot health, caring for existing foot problems and supporting older people in foot self-care is especially important in the home care context. However, this entails up-to-date foot care knowledge and practices. DESIGN: A cross-sectional correlational survey study design. METHODS: Nurses' knowledge of foot care was evaluated using the Nurses' Foot Care Knowledge Test developed for this study. The data were analysed with descriptive and inferential statistics. RESULTS: Nurses (registered nurses, public health nurses and licensed practical nurses) from public home care (n = 322, response rate 50%) participated the study. Nurses' knowledge in foot care varied. The knowledge scores were highest for skin and nail care and lowest for the identification and care of foot structural deformities. Longer working experience in the current work place and participation in continuing education explained higher Nurses' Foot Care Knowledge Test scores. CONCLUSIONS: Nurses need more knowledge, and hence continuing education, in the foot care of older people to effectively prevent, recognise and care for foot problems and promote independent living in the community. RELEVANCE TO CLINICAL PRACTICE: Nurses' have clinically relevant knowledge gaps. Therefore, foot care knowledge of nurses needs to be improved by continuing education in clinical settings. Adequate foot care knowledge among nurses is important to identify, prevent and care foot problems especially in older people.

Alterações podais e mobilidade em idosos atendidos em um ambulatório de geriatria / Modificaciones podales y movilidad en ancianos asistidos en un ambulatorio de geriatría / Podal changes and mobility in elderly assisted in geriatric outpatient clinic

Objective: to determine the most frequentpodal changes and their harm in the mobility in elderly outpatients. Method: this descriptive study was conducted with 121 elderly people who were treated in a geriatric outpatient clinic of a university hospital. Data were collected through interviews subsidized by structured tool and analyzed using descriptive and inferential statistics. Results: we observed high incidence of feet problems, especially in women and the young elderly, highlighting foot pain in the majority of respondents. There was also a predominance of elderly with partial independence. Conclusion: it is identified the need for special attention to the health of aged people who reports pain in feet, since this tends to restrict their usual activities, causing decreased quality of life, immobilization and possible falls.

Objetivo: verificar alterações podais mais frequentes e o prejuízo destas na mobilidade de idosos em atendimento ambulatorial. Método: estudo descritivo, realizado com 121 idosos que foram atendidos em um ambulatório de geriatria de um hospital universitário. Os dados foram coletados através de entrevista subsidiada por instrumento estruturado e analisados por meio de estatística descritiva e inferencial. Resultados: verificou-se alta incidência de problemas podais, especialmente nas mulheres e idosos jovens, destacando a ocorrência do pé doloroso na maioria dos entrevistados. Houve também predominância de idosos com independência parcial. Conclusão: identifica-se a necessidade de atenção especial à saúde do idoso que relata dor nos pés, visto que este tende a restringir suas atividades habituais, causando diminuição da qualidade de vida, imobilização e possíveis episódios de quedas.

Objetivo: verificar las modificaciones podales más frecuentes y el perjuicio de estas en la movilidad de ancianos en una clínica geriátrica. Método: estudio descriptivo, realizado con 121 ancianos que fueron asistidos en un ambulatorio de geriatría de un hospital universitario. Los datos fueron recolectados através de entrevistas subvencionadas por instrumento estructurado y analizados mediante estadística descriptiva e inferencial. Resultados: se verificó alta incidencia podales, especialmente entre las mujeres y ancianos jóvenes, destacando la ocurrencia del pie doloroso en la mayoría de los encuestados. También hubo un predominio de pacientes de edad avanzada con independencia parcial. Conclusión: se identifica la necesidad de prestar especial atención a salud del anciano que relata dolor en los pies, ya que este tiende a restringir sus actividades diarias, causando disminución de la calidad de vida, inmovilización y posibles episodios de caídas.

Principles of preventative foot care.

The lower extremities of the body, particularly the heel and ankle, are at risk of ulceration, skin tears and other forms of trauma. This is especially so in today's health-care environment, where society is faced with the challenges of an ageing population, alongside an increased incidence of diabetes, vascular insufficiency, obesity and dermatological conditions, all of which pose both clinical and economic challenges to health-care providers. Once established, damage to the foot can have a detrimental impact on the patient's overall wellbeing, often over extended periods of time, with some patients spending many years within the health-care system. Advanced wound care products tend to have a strong focus upon management of tissue damage, infection, maceration and the promotion of an optimum environment to facilitate the healing process. This clinician-patient collaboration product review challenges traditional ideals and explores the impact of using an adherent soft silicone foam dressing in maintaining skin integrity and preventing tissue damage in those high-risk patient groups.

Foot assessment and care for older people.

Nursing and healthcare literature about foot care focuses predominantly on people who have diabetes. There is a lack of clarity about which health and social care professionals should provide foot care to patients who can no longer manage to carry out this activity of daily living but do not have diabetes. This article explains why patients may no longer be able to look after their own feet and aims to give health professionals guidance on foot problems, assessment and care, and advise them on when it is appropriate to refer patients for specialist advice.

Developing a sustainable foot care clinic in a homeless shelter within an academic-community partnership.

Nursing faculty are confronted with the need to design community learning activities with vulnerable populations to prepare students for nursing practice. The creation of sustainable academic-community partnerships with agencies providing care to underserved populations meets this challenge. This article describes the development and implementation of a foot care clinic in a homeless shelter, created through a model of curricular integration, faculty engagement, and a long-term academic-community partnership. A transformative pedagogical approach based on service-learning was used to facilitate student understanding of social justice through activities that promote citizenship, develop advocacy skills, and increase knowledge and skills related to the role of the public health nurse in the community. The process of designing and developing a community clinical learning activity and the essential components for sustainability are discussed. Student outcomes are addressed. Recommendations for implementing a foot care clinic within an academic­community partnership are outlined.

Effect of an educational intervention on nurses' knowledge of foot care and on the foot health of older residents.

BACKGROUND: Older people have multiple foot health problems; therefore, nursing staff need to pay attention to the foot care of older people, especially in long-term care and nursing homes. The aim of this study was to investigate the knowledge of nursing staff (n = 16) regarding foot care, their foot-care activities, and the health of residents' (n = 43) feet in a nursing home before and after an intervention (educational program). METHODS: Nursing staff in a nursing home received a foot-care educational program that consisted of lectures and demonstrations. RESULTS: After the intervention, nursing staff knowledge of foot care and foot-care activities had partially improved, which was mainly seen in residents' skin health. CONCLUSIONS: The results of this study indicate that an educational program can change nursing staff knowledge of foot care and their foot-care activities. However, the educational program tested in this study needs further development.

[Pedicures and podiatry in psychiatry and social insecurity]. / La pédicurie podologie en psychiatrie et la précarité sociale.

Practicing pedicures and podiatry in a psychiatric environment is a particular speciality. This specificity arises not only from the disorders and complications encountered, but also from the connection established between the patient and the healthcare worker during treatment.

Foot health in older people and the nurses' role in foot health care--a review of literature.

AIMS: To describe foot health in older people and the role of nurses in foot health care. There is value in developing preventive measures in foot health care in older people, in creating educational programmes for nurses of foot care and in developing foot health evaluation instrument for nurses. METHODS: The literature was retrieved from the Medline and CINAHL databases between 1980 and January 2008. Altogether 35 articles were reviewed. FINDINGS: Based on the review, older people have a variety of foot health problems. Nurses have a theoretical knowledge of foot care, but they do not consider their clinical skills adequate. CONCLUSIONS: Future research should focus on evaluating in which areas of foot care nurses' knowledge is strongest and how effective their foot caring activities are. Nurses work closely with older people and are in a position to identify and prevent their foot health problems.