Health Essay Example: Saving a Foot

One of the many goals of Fresenius Kidney Care (FKC) in clinical practice is to prevent foot complications in End Stage Renal Disease (ERSD) for a patient with Peripheral Vascular Disease (PVD) and diabetes. Therefore FKC has developed and set guidelines for nursing staff to perform foot checks. Adherence to these guidelines will result in saving the patients foot, which is the primary goal here. Since I have been with Forest Park Dialysis Clinic, I have personal experiences of how foot checks saved patients' feet. In this narrative, I am going to share my experiences.

I started working at FKC Forest Park in 2016 where I received training on foot check. The training included LMS foot check class, shadowing with nurse preceptor and in-class training with nurse educators at Walnut Hill FKC. These pieces of training made me understand the importance of foot check and develop skills needed for foot check. After completion of the training, I have since started working independently as a nurse. However, I noticed that the graph, foot check completion per month on eQuip for the previous year 2016 between January and November foot check was never 100% completed. This is because most nurses at Forest Park FKC are travel nurses. So I took the obligation to ensure the 100% completion of foot checks per month.

I made sure that I identified patients with diabetes and PVD, and performed foot checks on them on a monthly basis or as needed. Looking at the foot check completion graph per month on eQuip for last year starting from December 2016 to November 2017, foot check completion has always been 100% and the six months trend is stable. The eQuip report translates that there was a higher risk of foot complications in 2016 than in 2017. This is because patients who did not receive foot checks in 2016 are at a higher risk of having foot complications.

In the year 2017, I saved the feet of three patients. Upon a foot assessment of the first patient, patient A, I noticed a wet milky sore between toes on the right foot. I documented and notified the clinical coordinator and MD. The MD, upon examining patient commended my effort. A referral was sent to the patient to see a podiatrist. Upon follow-up with the patient, the toes had healed completely. Patient A was advised to visit the podiatrist on a regular basis. The patient was educated on how to take care of their feet by self-examination and application of lotion but not between toes. A "taking care of your feet" handout was given to the patient for guidance. Therefore, it is upon me to ensure that the 2016 culture of partial foot examination is abandoned to prevent the feet amputation of patients.

The second patient, patient B upon foot assessment had very long toenails. MD was notified; a referral was made for the patient to see a podiatrist. A podiatrist now regularly cuts patients nails. If this was in 2016 and this patient fell among the percentage of patients who did not get foot checks done, the repercussions would have been vital. Again with timely identification and intervention a foot was saved. Patient C was wearing stockings and a worn out hard shoe with no lace that scratches his feet. Patient C was also educated on taking care of feet.

In conclusion, from my experiences above, the importance of following FKC policy and procedures on foot check can prevent foot complications and amputation can be seen. Foot checks save the feet through early identification, intervention, and education.