Archive for the ‘diabetic toenails’ Category

Diabetic Toenails: Watch for Change

Thursday, February 23rd, 2017

Changes in the diabetic foot can happen fast: here are the signs and types clinicians in wound care need to look for.

Diabetic Toenails: Watch for Change

 

As a wound care professional, chances are you’ve treated a number of nail conditions and abnormalities that occur among the general population. But when you’re working with diabetic patients, noticing and identifying variations is even more crucial. This is because change can happen more rapidly in the diabetic foot, and pathologies can ultimately lead to skin breakdown, foot ulcerations and infection. So, what causes the nails to change, and what exactly should you look for? We’ve got you covered.

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Wild On Wounds Conference Early Registration Savings

Friday, April 17th, 2015

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When you register early, you save $100 and you will have first choice in selecting all conference sessions. The early discount rate expires May 1, 2015.  Register today!

Industry and clinical experts will provide training, product demonstrations and will help answer your “hard to heal” wound questions.

Join us in Las Vegas, September 2-5, 2015 and network with hundreds of passionate wound care clinicians with the same goal in mind, to advance their wound care knowledge.

About WOW

Wild On Wounds is a national conference dedicated to clinicians who want to enhance their knowledge and learn current standards of care in skin and wound care. Attend lecture sessions, participate in hands-on workshops and learn all the new products and technologies from industry experts.

Full Conference Registration Includes:

  • Access to educational sessions over 3.5 days
  • Access to product experts during the exhibitor showcase
  • Lunch on each registered day
  • Poolside get-together with a robust buffet
  • FREE cyber cafe to check emails, complete onsite evaluations, etc
  • Complimentary collectible event T-shirt
  • And more!

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WOUND CARE CERTIFICATION – This Wound Care Certified (WCC®) course offers an evidence-based approach to wound management and current standards of practice to keep clinicians legally defensible at bedside.

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DIABETIC WOUND CERTIFICATION – This Diabetic Wound Certified (DWC®) course takes you through the science of the disease process, focuses on limb salvage and prevention, and covers the unique needs of a diabetic patient.

WCEI2015_OMS_BUTTON_revOSTOMY CERTIFICATION – This Ostomy Management Specialist (OMS) course will take you through the anatomy and physiology of the systems involved in fecal/urinary diversions. The course includes hands-on workshops and online pre-course modules.

 

CLICK HERE FOR COURSE DETAILS

 

Diabetic Patient Education

Monday, December 29th, 2014

Patient education plays a vital role in positive outcomes for our diabetic patient. Diabetic patients need to understand the importance of proper foot care and importance of good blood glucose control to maintain the integrity of their feet.

So what do our patients need to know? They need to work closely with their physician and the dietician to be sure their blood glucose levels are properly controlled. foot_mirror_between_toesThe ADA recommends an A1c below 7%.  They need to know how important it is to check their feet daily to catch any problems early. We as clinicians need to teach them how to do this and what to look for. Teach your diabetic patients to inspect their feet everyday. They can do this by having family members or caregivers check their feet, or they can use a mirror and do it themselves.

Explain to your patients what exactly they are looking for; cuts, sores, red spots, swelling, infected toenails, blisters, calluses, cracks, excessive dryness or any other abnormality. They should check all surfaces of the feet and toes carefully, at the same time each and every day. Explain to your patients to call their physician right away if they notice any abnormalities or any open areas. Other problems the diabetic patient should be aware of with their feet and report to their physician include tingling or burning sensation, pain in the feet, cracks in the skin, a change in the shape of their foot, or lack of sensation – they might not feel warm, cold, or touch. The patient should be aware that any of the above could potentially lead to diabetic foot ulcers.

Instruct your patients to wash their feet every day, but not soak their feet. Use warm, NOT hot water – be sure they check the water temperature with a thermometer or shoe_fittheir elbow. Dry feet well, especially between toes. Apply lotion on the tops and bottoms of their feet but not between toes. Trim toenails each week and as needed after bath / shower, trim nails straight across with clippers, smooth edges with emery board.

Wear socks and shoes at all times, the diabetic patient should never be barefoot, even indoors. Have them check their shoes prior to wearing, be sure there are no objects inside and the lining is smooth.  Instruct them to wear shoes that protect their feet; athletic shoes or walking shoes that are leather are best, be sure they fit their feet appropriately and accommodate the foot width and any foot deformities.

For our diabetic patients, glucose control is a key factor in keeping them healthy, but patient education and understanding of proper foot inspection and what findings to report to their physician are just as important for the well being of our diabetic patient.

Free Webinar “How-To: Diabetic Foot Exam Made Easy”. Use Promo Code: DFOOT  through 12/31/15.

Tips for Trimming Those Diabetic Toenails

Monday, December 8th, 2014

Make sure you have the proper tools. A set of toenail nippers, nail file, and orange stick are typically used.  Always follow your facility or healthcare’s settings policy for nail clip blog imagesinfection control. Single use disposable equipment is favorable.
Nails are easiest to trim after they have soaked for 10 minutes in a footbath to soften them. It is important to remember and educate our patients that the soaking of a diabetic patients feet should only be done by a healthcare professional. You can save some time by cleaning under the patient’s toenails with an orange stick wiping on a clean washcloth in between each toe while the feet are soaking.
After soaking and washing of the feet are completed, dry the patient’s feet completely. Wash your hands and put on new gloves to trim the toenails. Use your dominant hand to hold the nipper. Start with the small toe and work your way medial toward the great toe. Squeeze the nipper to make small nips to cut along the curve of the toenail. Be careful not to cut the skin. Use your index finger to block any flying nail fragments. Nippers are used like a pair of scissors – make small cuts, never cut the nail in one clip all the way across the nail. Never use two hands on the nipper. The nail is trimmed in small clips in a systematic manner. The nail should be cut level with the tips of the toes, never cut so short or to break the seal between the nail and the nail bed. The shape of the nail should be cut straight across and an emery board should be used to slightly round the edges. When filing nails always use long strokes in one direction, avoid using a back and forth sawing motion.
When all toes have been trimmed and filed, remove gloves and wash hands. Apply clean gloves and apply lotion to the top of the foot and to the bottom of the feet, rubbing lotion in well, wipe excess lotion off with a towel. Put patients socks and shoes back on as needed. Wash your hands again and smile, you are done!

FREE WEBINAR:  Skin and Nail Changes in the Diabetic Foot.  Click Here and use coupon code: NAILS through 12/31/15.

 

 

Diabetic Foot Ulcer Assessment and Hands On Lab

Wednesday, October 1st, 2014
Donna Sardina RN, MHA, WCC, DWC, OMS

Donna Sardina RN, MHA, WCC, DWC, OMS

Do you know the components of a Diabetic Foot Exam? It is so important that all of us in wound care know the steps to preventing foot ulcers on our diabetic patients.  And that starts with a routinely scheduled comprehensive foot exam.

Donna Sardina took us through all the aspects of a comprehensive exam during the pre-conference session “Diabetic Foot Assessment.”

The key word here is comprehensive. A proper exam involves much more than just a test of sensation using a Semmes Weinstein monofilament or a tuning fork. What about skin color, texture, temperature, foot deformities, nail deformities, glucose control, and critically important perfusion status. Did you know that it is estimated that 50% of amputations in diabetics are a direct result of improper footwear? That statement gets my attention every time I hear it.

In this session we learned how to examine our patient’s footwear for signs of trouble. Included in the handouts was a document “Diabetes: Shoe Fitting Tips” that will be extremely helpful when putting our knowledge into practice. In recognition of the fact that we are not all specialists in the diabetic foot, Donna shared a “Simplified Sixty Second Foot Screen” published by Dr. Sibbald in 2012. It is a validated tool that has just 10 items on it that can be completed in less than 60 seconds. This seminar was empowering to all who attended and gave us the tools we need to make a difference in this at risk population.

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Wild On Wounds National Conference Brings Back the Maggots to Las Vegas!

Tuesday, June 3rd, 2014
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This is just one of the sessions you can enjoy at our
National Wound Conference
Session 305 
HANDS ON:
Maggot Debridement Therapy
Dr. Ronald A. Sherman, M.D., M.Sc., D.T.M.H., Director, BioTherapeutics
We are pleased to welcome back Dr. Sherman, leading expert in maggot therapy and currently Chairman of the Board of Directors of the non-profit BioTherapeutics, Education and Research (BTER) Foundation, which supports patient care, education and research in maggot therapy and the symbiotic medicine.
Taught in two sessions, this course will give you the didactic and the practical hands on education on maggot therapy. Learn about the history, current status, mechanisms of action, as well as indications and contraindications for maggot therapy. Then put all that to use when you actually learn the technical aspects of maggot debridement therapy by applying live maggot dressings to mock wounds.
This session has limited seating and fills up fast so don’t wait.
 REGISTRATION INCLUDES:
  • 3 days filled with wound care education
  • 2 days of vendor showcase exhibits
  • Lunch all 3 days with a lunch speaker on day 3
  • Party poolside with a robust buffet and drinks!
  • Complimentary collectible event T-shirt
  • and MORE!

The blank white buttons with download pictogram            The blank white buttons with download pictogram

 

Diabetic Wound Certified Nurses Paying It Forward in Philadelphia

Tuesday, May 14th, 2013

Diabetic Wound Care certified nurses had a dream to create a free diabetic foot screening clinic and open it up to the city of Philadelphia, PA. Their dream came true.

Philadelphia Nursing Team, WCC's and DWC's getting ready to open up the clinic.

Philadelphia Nursing Team, WCC’s and DWC’s and Dr. Fanelly getting ready to open up the clinic.

Wound Care Education Institute’s (WCEI®) clinical team presented a session last year called “Paying It Forward” at our annual “Wild on Wounds” convention. This session was all about developing and coordinating free community diabetic foot screening clinics. We walked attendees through every step necessary to conduct such a clinic, from choosing a location to marketing and funding, and including logistics such as station supplies and staffing.

As a result, Stanley A. Rynkiewicz III RN MSN WCC® DWC® CCS and Administrator at Deer Meadows Home Health was inspired to coordinate a one day clinic in his home town of Philadelphia. He asked if WCEI could help him coordinate the event making it available to the whole city. We were thrilled at the invitation!

The event took place on Saturday May 11th with staff that included volunteer nurses, Wound Care Certified (WCC®) and Diabetic Wound Certified (DWC®) clinicians and a local podiatrist and co-sponsor, Dr. John M. Fanelly DPM.

The clinic was a huge success!  Close to 100 Philadelphians came from all over the community, ranging in age from 35-85 years.  We were a welcome sight to them and you could see the appreciation in their faces.  They came to us with conditions that ranged from calluses to fungus and included hammer toes, Onychogryphosis (also known as “ram’s horn nails”), diabetic ulcers and Charcot foot .

Polymem Silver Toe dressing to combat bioburden

Polymem Silver Toe dressing to combat bioburden

We will never forget Willie, an older man who walked with a slow shuffle and a big smile. Because he had not seen a doctor in many years, he was thrilled to have his feet checked. When he took off his slipper we saw the “ram’s horn toe nails” shown in this photo. They had not been cut in years and were excessively thick and curled under and over.

Ram Horn Nails

Ram Horn Nails

Our post clinic meeting discussions made it clear that our outreach work has just touched the surface of a great need. Much more needs to be done and our knowledge and expertise has the potential to have enormous impact. There are many more Willies out there that need our help.

We plan to share our experience in detail at this year’s Wild on Wounds annual convention in Las Vegas on September 11-14, 2013. Our hope is to inspire more clinicians to do this in their own communities across the country.

Thanks again to all the wonderful nurses who donated their time on a very long Saturday and to the wonderful sponsors:  Deer Meadows Home Health Select DataFerris Manufacturing (Polymem Dressings) / Dr. John M. Fanelly DPM and Wound Care Education Institute.

 

Trimming Those Tricky Diabetic Toenails

Thursday, March 7th, 2013

diabetic blog pic

You are getting ready to trim your diabetic patients toenails.  What exactly does that all involve?  Well, first you need the proper tools.  A set of toenail nippers, nail file, and orange stick are typically used.   Always follow your facility or healthcare’s settings policy for infection control.  Single use disposable equipment is favorable.

You have gathered your equipment to trim the patients toenails, now what?  Nails are easiest to trim after a bath or soak for 10min to soften nails.  The soaking of diabetics feet should only be done by a healthcare professional. You can clean under the patients toenail with an orange stick (wearing gloves), wiping on a clean washcloth in between each toe during soaking. .

After soaking and washing of the feet are completed, dry the patients feet completely.  Wash your hands and put on gloves to trim the toenails.  Use your dominant hand to hold the nipper.  Start with the small toe and work your way medial toward the great toe.  Squeeze the nipper to make small nips to cut along the curve of the toenail.  Be careful not to cut the skin.  Use your index finger to block any flying nail fragments.  Nippers are used like a pair of scissors – make small cuts, never cut the nail in one clip all the way across the nail.  Never use two hands on the nipper.  The nail is trimmed in small clips in a systematic manner.  The nail should be cut level with the tips of the toes, never cut so short or to break the seal between the nail and the nail bed.  The shape of the nail should be cut straight across and an emery board should be used to slightly round the edges.  When filing nails always use long strokes in one direction, avoid using a back and forth sawing motion.

When all toes have been trimmed and filed, remove gloves and wash hands.  Apply clean gloves and apply lotion to the top of the foot and to the soles of the feet, rubbing lotion in well, wipe excess lotion off with a towel.  Put patients socks and shoes back on as needed.  Wash hands and smile, you are done!

For your patients who are trimming their own toenails at home teach them the following simple instructions:  Be sure you have good lighting. Trim toenails after bathing, dry feet well, especially in between the toes.  Start with the little toe and work your way into the great toe.  Use small cuts, never cut the toenail across all at once.   Cut straight across and use a nail file to smooth edges.  Apply lotion to the bottom and tops of the feet, never in between the toes.  For patients with thickened toenails or yellowed toenails, recommend a foot care specialist like a podiatrist cut their toenails.

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