Assess the feet of individuals with diabetes and provide advice on maintaining healthy feet and managing foot problems
Overview
This standard concerns assessing the condition of the feet of an individual with diabetes to determine risk status, and taking the appropriate action, which may include a referral for treatment, providing advice, or negotiating a care plan.
The activities described in this standard may follow a referral from a preliminary examination, or may be a first examination of the feet.
Users of this standard will need to communicate effectively to meet individuals' needs and wishes and work in line with health and safety legislation, policy and practices.
Users of this standard will need to ensure that practice reflects up to date information and policies.
Performance criteria
You must be able to:
P1. identify and agree the roles and responsibilities of yourself and others in assessing the feet of individuals with diabetes
P2. communicate with individuals throughout the discussion and examination in a manner which is appropriate to them and which encourages an open exchange of views and information
P3. confirm that the individual understands the purpose and nature of any examinations which need to be carried out, and gives consent
P4. assess and reinforce the individual's understanding of the potential effects of diabetes on vascular and neurological problems in the feet and lower legs
P5. through discussion with the individual, gather information on
P5.1 relevant medical history
P5.2 any symptoms of problems in the feet and lower legs
P6. examine the skin condition of the feet and lower legs and assess for sensory neuropathy, using appropriate tools
P7. examine any current infection and ulceration, and assess ulcer type
P8. assess for and identify any foot deformities
P9. assess vascular status for the presence of peripheral arterial disease by palpating pedal pulses
P10. assess joint mobility and identify any biomechanical problems
P11. examine the individual's footwear and assess its suitability for foot type and risk status
P12. discuss the results of the examination with the individual in an appropriate manner, and at a suitable level and pace
P13. explain any evidence of problems or risks revealed by the examination, including any areas of uncertainty which may require further tests
P14. arrange for further examination or treatment, where this is indicated by your risk assessment
P15. help the individual understand what specific actions they can take to
P15.1. maintain the health of their feet
P15.2. address any particular problems and risks revealed by the examination
P16. provide information on footcare in a suitable form for the individual, to reinforce their understanding
P17. agree when the individual will next come for examination, leaving an interval appropriate to the risks you have identified
P18. Complete all documentation required for assessing the feet of individuals with diabetes
Knowledge and Understanding
You need to know and understand:
K1 how to access and interpret all relevant work instructions, legislation, guidelines, policies, procedures and protocols needed to assess the feet of individuals with diabetes
K2 the scope and limitations of your own competence, responsibilities and accountability as it applies to your job role
K3 the principles, practice and procedures associated with informed consent
K4 signs and symptoms of diabetes
K5 normal and abnormal blood glucose and HbA1c values
K6 how to monitor glucose levels, HbA1c, blood pressure
K7 typical progressive patterns of diabetes
K8 the importance and effects of individual education and self management
K9 the psychological impact of diabetes, at diagnosis and in the long term
K10 how to gather information from individuals about their health
K11 how to work in partnership with individuals
K12 the social, cultural and economic background of the individual
K13 the impact of nutrition and physical exercise
K14 the effects of smoking, alcohol and illicit drugs
K15 the effects of, and how to manage, intercurrent illness
K16 how to manage hypoglycaemia
K17 the medications used to manage diabetes
K18 the long term complications of diabetes and when they are likely to occur
K19 how to examine feet and assess risk status
K20 how to monitor cardiovascular risk
K21 how to monitor for renal disease
K22 how to monitor for diabetic retinopathy
K23 sources of information on diabetes including support groups.
K24 how individuals can access local facilities for exercise and physical
activity, education and community activities
K25 how to complete and safely store all documentation required for assessing the feet of individuals with diabetes