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I do a lot of out of office services. Nursing homes, home care, etc. I carry all my equipment in a large fishing tackle box. My question is this. How are you supposed to maintain sterility between patients? I generally use a liquid disinfectant which I keep my instruments submersed in a steel tray as I go room to room or set up in a room, and use copious amounts of alcohol during treatment(debridement of nails, hyperkeratotic tissue, etc, and betadine soln. prn.) Of course going to a patient home I do not soak the instruments between home visits, but still use alcohol to clean off all instruments and the patients feet. Is there anything else that I can do?(I do not think it would be possible to carry 20 or more different set of sterile tools with me each day for each and every patient._

Thanks.

That is below a minimum standard of care. You need an individual pack for each patient that has been autoclaved.

If you are in the UK, you may want to read what happened in the second case in the first post in this thread.

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In my Department we service a few nursing homes attached to the hospital, as well as visiting an off site campus of the hospital, and manage to carry sufficient individual sterile sets of instruments to achieve this. Try two fishing/tool boxes!

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Stephen Tucker
Eastern Health
Podiatry Manager

My location

You don't have to carry them if they're on wheels!!! I used to do a lot of nursing home work as a new grad :( , and I'd take all of my equipment in a luggage case with wheels, you can usually get cases that are fairly heavy duty and hold a lot of weight, and if you keep all of your "bits and pieces" in plastic boxes it still fits in fairly easily. I had separate containers for dressings, tapes, scalpel blades etc etc and it's easy to wipe down the individual containers to keep them clean.

Just a suggestion...

Regards

Donna :)

I still can't believe there are Podiatrists who feel they can ignore the Sterilisation Act Australia ....was it 1985 Admin ??.... Why ?! Who is going to be the Pod reported on on Today Tonight or another Current Affairs programme for being the Podiatrist to bring our profession down ? and risk our insurance premiums, and I am sure there would be a loop hole for the insurance companies to not cover you.

I do home visits all day and love sterilisation and inform all my patients about the Meditracking system I use and my infection control process for a domicilliary practice. My patients are very well informed.

Why should I spend all the extra money on ster. bags, blueys, viraclens, tracking stickers and documenting books etc, only to find out other Pods don't sterilise and still charge the same fees ?

My main question I ask any person is...."are these instruments clean enough to be used on yourself after the last couple of fungal patients and the HIV or Hep B patient you treated...would you accept these instruments ?"

I have recently found out that 2 Podiatrists on the Gold Coast (Aust) don't sterilise....now what should I do ??

Trudi

RuddyDuddy

Could this be a wind up if not then fair play for having the balls to ask that question publicly. You really should have a sterile pack of tools for each patient. The first chiropodist I ever met boasted that he did 30 - 40 patients a day in institiutions.
Later I found that he and others used only 2 sets of tools and immeresed one set in Dettol while using the other and went thru a whole day like that. Horrified I was and that was nearly 10 years ago. When I did nursing and care homes I took my small autoclave with me and 5 sets of tools, I only did about 10 patients per day ( I did proper chiropody and not just a nail cutting service) and put them in the autoclave at lunch time.(not the patients, the tools :) )
Nowadays I do half a dozen domicillaries and only do one or two registered care / EMI facillities per week and and always take enough pouched tools for the job.

More important I think is how do you clean the tools between patients. I believe effective cleaning is more important than sterility. If its not clean then it almost certainly will not be sterile whatever type of sterilisation you use.

Do you need to do 20 patients a day, I charge £23/person plus travel charge outside my town but I know of some who charge as little as £10 each.

I think you need to charge enough so that you do not have to compromise yourself and your patients. Some of my patients, that live say 15 miles away, pay up to £45 per visit. I still prefer my clinic environment as a work place tho.

Danny

Try speaking to the A Pod A...maybe they can give you some advice?

Report them to the Podiatrists Board of Queensland they can investigate the claim.

In Qld as in the rest of Australia the standard adopted is the Australasian Podiatry Council’s Infection Control Guidelines

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Stephen Tucker
Eastern Health
Podiatry Manager

My location

I work in nursing homes and hostels one to two days per week. If I anticipate to see 26 patients, I take 27 sets of instruments. Just in case. I wouldn't want a dirty set of instruments used on me, and I won't do it to anyone else. As Donna suggested, hardware strores carry a good range of rolling tool boxes that are good for this.
Beth.

I do nursing home work, and do between 10 and 12 patients per visit. I don't think I'd want to do as many as 20 plus in a day. Although it is mostly nail cutting and filing, I do what ever is necessary. I think if I was doing too many patients their level of care would be compromised. I, like some of the other members take my autoclave with me and sterilise lunchtimes.