The Effect of a Nurse Centered Foot Care Protocol on Nurse Competency and Confidence

Objective:  To determine whether nurse training in foot assessment and foot care increases nurse confidence and competence in foot care.

Background:  While working in a rural inpatient healthcare facility where there is a high incidence of lower extremity complications, it was noted that many nursing staff do not follow a centralized foot care protocol.  Although there are policies in place to guide staff on foot care, the working reality is that feet are neglected, and nurse confidence is poor pertaining to the care of feet.

Method:  Nurses at an inpatient facility were recruited to participate in a 30 minute workshop designed to improve nurse knowledge of foot care and assessment.  Nurses were taught to use a 60 second foot assessment tool and also viewed a 3 minute nail trimming video.  A pre and post-test study design was used to evaluate nurse confidence and competency in assessment and nail care.  A 60-day post-test survey will also be completed by participants to determine ongoing use of the assessment tool and training.

Results:  The expected findings are that nurse training does increase nurse confidence in providing foot care.   Nurses are able to incorporate an assessment instrument that increases competency into daily care.  Podiatry care in the facility will increase after the workshop but decrease over time as nurse assessments increase, and lower extremity complications are found early. 

Conclusions:    A successful foot care training program impacts nurse confidence and competence in several areas.  First the use of a valid instrument for assessment standardizes nurse practice in foot assessment.   Next, it adds to the evidence-based culture into which health facilities must transform in order to give cost-effective care.  Lastly this research endorses findings from researchers in inter-related disciplines who have studied nurse confidence in foot care.