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Infection Control Procedures for Foot Care Nurses

As is true with any medical industry, proper infection control is vital in the business of foot care nursing. Protocol, procedure and documentation requirements are outlined below. For additional information, please contact us directly or browse our selection of free foot care forms and resources.

There are a variety of necessary and helpful supplies and documents you'll use every day when providing foot care to your patients. A few of these include sterilization guidelines, infection control protocols, a MetriCide use log and MSDS sheet, consent forms and proper foot care instruments. Thorough documentation and attention to detail will ultimately make your job easier and help ensure your own safety as well as the safety of those around you.

Sterilization versus Disinfection

Both disinfection and sterilization properly decontaminate surfaces. The difference between these processes is that disinfection removes microorganisms while sterilization kills them. In an environment where contact with blood occurs, sterilization is absolutely necessary in order to prevent the possible spread of antibiotic-resistant bacterial infections such as VRE and MRSA.
However, in instances where non-critical items are used, and the transmission of infectious agents has not been documented, the CDC recommends a low or intermediate-level disinfectant instead. "Non-critical items that do not contact non-intact skin and/or mucous membranes" include nail cutting devices, burrs and scalpel handles.

Our preferred intermediate-level disinfectants include phenols, iodiphors, alcohols and chlorine.

Cleaning versus Disinfection

As we've already discussed above, disinfection is the removal of microorganisms from surfaces. It's important to note that disinfection is not a substitute for cleaning, which removes foreign materials with soap and/or water.
Cleaning should always be completed before disinfection since particles on the surface of your instruments will interfere with the efficacy of the disinfectant and dry onto the instrument after disinfection has occurred.

The Disinfection Process

Disinfection fluids can be placed in plastic, metal or glass containers, depending on your preference. An instrument tray like this one allows you easily to remove your instruments without touching chemical solutions, while plastic containers with snap-on lids will keep your soaking instruments safely contained when traveling*.

Bleach

Although bleach is a very effective disinfection fluid, it is important to note that it is more corrosive to instruments than other solutions. If you choose to use bleach for disinfection, dilute your solution 1:10 and apply a special surgical instrument lubrication at least once weekly. Lubricants for surgical instruments contain additives that dissolve organic debris while depositing an anti-corrosive microfilm onto the instrument's surface.

When to Sterilize

In accordance with CDC guidelines, all instruments which have come into contact with blood or mucous membranes must be sterilized. This includes blood from cuts and scrapes, open sores and saliva. Because the popular sterilization solution Cidex has been discontinued by the manufacturer, we now recommend MetriCide, which is a safe and effective alternative with the same formulation as Cidex.

Dust

Nail dust from sanding can lead to conjunctivitis, itching, tearing, sneezing, asthma, bronchitis and coughing. Always use a surgical n95 mask in order to filter micro-particles properly. In addition, you may find that a nail dust extractor may help you. Nail dust extractors have been shown to be effective in studies, with a minimum efficacy of 24.6% and a maximum of 91.6%

Fungal Infections from Sanding

While fungal elements can enter the lungs through dust, they are not capable of growing there since they have evolved to live only on keratin surfaces. However, because air-borne illnesses such as MRSA and C. Difficile are capable of entering the lungs via dust particles, it is important to exercise caution when sanding.
If you are aware of a potential risk of diseases like this existing where you are working, you should not sand nails with a Dremel or a manual file.

*Not all containers with snap-on lids provide a spill-proof seal. When purchasing your travel container, always ensure that it is advertised as 100 percent leak-proof such as this travel germicide tray.