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I have a potential private domicillary patient who has bought her own set of reusable podiatry instruments to keep costs down when she used to go to an FHP. The patient would like to carry on this arrangement. Normally I would use disposable instruments. The patient looks after her own set of instruments and are only ever used on her. Since treatment is just a medical nail cut and callous debridement I don't see a problem with this arrangement. As a new podiatrist I would appreciate thoughts from more experienced practioners about any problems or potential legal risks to this arrangement. Has anyone else had patients buy their own equipment and expect you to use them?

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"A thing may be too sad to be believed or too wicked to be believed or too good to be believed; but it cannot be too absurd to be believed in this planet of frogs and elephants, of crocodiles and cuttle-fish"
G.K. Chesterton

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I´m not sure of the laws in the UK, but don´t instruments need to go through a autoclave process before they can be used ? I would assume even if it is them same patient.

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Mike Weber.



Crazy Mary

Hence my unsureness. I know legally all MY instruments have to sterilised before use, but these instruments belong to the patient, not to me. Does that distinction make any difference?

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"A thing may be too sad to be believed or too wicked to be believed or too good to be believed; but it cannot be too absurd to be believed in this planet of frogs and elephants, of crocodiles and cuttle-fish"
G.K. Chesterton

So say you let the patient " mrs Smith" have here own instruments.

You would need to make sure these were sterile. There are 2 ways the patient buys a steriliser which does not sound likely or you have to take the instruments wash, bag and sterilise them, then on the day of Mrs Smith appointment remember pack them in your dom bag, recored all the approriate date and sterilised time etc, probably have to orgainise to have repairs or nippers sharped and then get the patient to pay for these etc etc .

I do not know about the legal issues but this seems a huge pain for you and I would put it in the too hard basket.

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Mike Weber.



Crazy Mary

If you are a member of The Society of Chiropodists and Podiatrists, contact Kay Blowes, the prof practise officer. She is apparently highly approachable and even if she can't help you, she would be able to find out more!

As an aside, due to the risk of infection from "pedicures" in the "nail industry" it is quite common to see advice (esp in the USA) for 'customers' to buy their own instruments to be used on only themselves. See some of the threads tagged nail industry.

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Craig Payne
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

Very simple, if you use their instruments and you have no knowledge of the "sterilisation status" then should there be any complications for whatever reason "your butt is hanging out in the air".
Do not compromise your status and you will be safe, take short cuts and you are on your own.

Podolog,
I would agree with the above.
You have a "duty of care" to this patient and if you are an SCP Member, recommended Minimum Standards of Clinical practice which includes a decontamination and cross-infection protocol. In the event of a problem/litigation you'd have a hard job trying to explain why you chose to disregard these.

It's all very well saying that its "only a nail-cut and a bit of callus". What would happen if you turned up one day and she presented with sepsis, an ulcer or bleeding fissures? How would her instruments be decontaminated then?

You are a Podiatrist, so why would you want to copy the standards of the unregulated sector? As an HPC registrant you need to maintain standards and this costs money. If the patient doesn't want to pay the extra they should go back to the FHP.

Sounds harsh I know, but you're running a business as well as providing a service and cutting corners isn't the way to go. The nicest patients have been known to turn nasty when they get the whiff of a compensation payout.


Dido

I also agree with the above comments.

You are a professional and have a code of conduct and standards by which you must practice. In our country this is the law. Instruments must be sterilised and standards adhered to. I wonder how supportive your professional indemnity insurance company would be if anything were to go wrong. Don't risk it - do what you know is right.

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Gavin Daly.
http://www.podcare.com

Podalog

I think many more will be coming unpon this issue in the future, I did read somewhere on the web clients of nail bars were recomended to purchase and take their own instruments in due to high infection rates in this industry.

My answer will be "your relative or close friend (unregulated non proffessional) might be able to use these but not a Podiatrist who is bound by audit and regulations".

Jude