Status of Foot Care for Chronic Dialysis Patients and Issues With Implementation

Friday, 28 July 2017

Sachiko Tamura Sr., PhD, RN
Department of Nursing, School of Nursing, Kanagawa Institute of Technology, Atsugi, Japan

Purpose:  We are developing a foot care that will prevent foot lesions for chronic dialysis patients. As the first step, we conducted a survey of the actual conditions in order to grasp the status and issues with implementation.

Methods:  Head nurses at all dialysis facilities in one prefecture were posted question sheets we prepared, which were later collected.


Results:  Responses for these question sheets were obtained from 33 of the 40 facilities targeted. Foot care was carried out on all dialysis patients at 46% of the facilities. The implementation period was during dialysis for 76% of the facilities, while a foot care checklist was used at 70% of the facilities. The most common types of care were observation of the foot and walking (91%), provision of knowledge of foot diseases and assessment of lifestyle (65%), instruction for how to care for one’s own feet and the application of ointment (61%), cutting and filing toenails (52%), and foot baths (48%). Issues with the implementation of foot care included problems with ensuring enough time (86%), lack of knowledge and skills for foot care (73%), lack of a proper environment for foot care (50%), and the burden of recording in checklists, etc. (47%).

Conclusion:  There is a high level of interest in foot care among dialysis nurses. In many facilities, a foot check chart is used alongside observation and care, but in terms of preventing foot lesions, there are issues with a lack of assessment and implementation of care, and in support for self-care. In order to prevent foot lesions in patients undergoing chronic dialysis, it is necessary to further enhance assessment and care, and it is very important to use a simple yet effective checklist to that end. Recording in checklists and so on needs to be improved to allow it to be done on a daily basis without it causing a burden.