Certified foot care nurse place of practice

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What is a Certified Foot care Nurse - CFCN 

 A Certified foot care nurse- CFCN is a registered nurse, registered practical nurse, nurse practitioner, or a licensed practical nurse who has taken in addition to their formal training as a nurse taken specialize training in Advanced Nursing foot care or a Basic and Advanced Nursing Foot care program from an accredited training institution training nurses in Advanced Nursing Foot care.and have pass the theoretical and practical hours performing a minimum of 20 hours of advanced foot care treatment using the tools of Advanced foot care, and following the competency standard of the Certified foot care nurse- CFCN
What is Basic Nursing Foot care

This is taught in the basic nursing program and includes knowledge and skill in the following areas: • Anatomy and physiology of the feet and lower extremities • Common micro‐organisms of the feet • Asepsis and infection control
​• Complications of diabetes and the effect • Documentation and reporting of treatment .
What is Advanced Nursing Foot Care
In addition to the skills in Basic Nursing Foot care, Advanced Nursing Foot Care is considered a specialized skill and treatment in nursing foot care. The Foot care nurse provides treatment to high-risk clients including the geriatric population, those with arthritis, autoimmune disease, and diabetes.
Many Advanced foot care nurses fill the gap where a chiropodist may not be able to, the foot care nurse role is holistic in her assessment and treatment while utilizing best practice in foot care, infection control and assessment in the provision of safe care.
The foot care nurse understands the importance of assessiing the high risk client diagnosed with diabetes and is practice using best practice in diabetic foot care assessment as per Registered Nurses of Ontario 2007 practice guideline.

The foot care nurse understands the nail and foot disorder of the geriatric population, including the use of accessing for decrease sensation using the Semmes Weinstein10 gram monofilament testing.

The foot care nurse can perform the diabetic foot screen assessment, the Lower Extremity Amputation Prevention Program (LEAPS) to identify client at high risk for amputations as a result of diabetes.
The foot care nurse also understands the importance of foot health as part of the overall care program for individuals diagnosed with diabetes and the importance of foot health, and intervention in illnesses such as diabetes peripheral neuropathy and vascular disease.

The foot care nurse recognizes that adequate timely foot care can help reduce the serious complications that often arise in clients with diabetes, and how the high risk client mobility can be enhanced through treatment of overgrown and ingrown nails that cause debilitating pain over time.

The foot care nurse recognizes the impact of the aging process on clients with respect to vision, strength, and flexibility, that make foot care a challenge, and require skilled assistance overtime. The foot care nurse offers commitment to care that addresses the fundamentals of effective foot maintenance for basic and advanced foot care hygiene as per the Canadian Diabetes Association CDA Clinical Practice Guidelines CPG 2018 checklist Do”and Don’t for foot care:
The foot care nurse treatment activity involves the removal of tissue below the dermis. The restricted activity listed in the Health Professions Act, LPN Regulation 2003 (5[a]) authorizing advanced foot care states: “Only regulated members on the specialized practice register and who are specifically authorized by the Registrar may perform the restricted activity of cutting a body tissue, administering anything by invasive procedure on body tissue or performing surgical or other invasive procedures on body tissue below the dermis for the purposes of performing the following activities:

The Advanced Foot care Nurse performs invasive foot care procedures: Including: removal of corns callus issue below the dermis, provide invasive foot care:‐principles and application of padding‐contraindications of padding
Operation of a cordless rotatory tool that is safe for use on humans, using disposable sanding bands, using safe infection control practices, operation of a disposable foot file with disposable abrasive pad to file calluses.
Use disposable set of sterile tools on each client's when providing foot care in a client home, or in a clinical setting where there is not an Autoclave or Steam Sterilizer onsite.
The Foot care nurse will disposed of used sterile disposable tools after each client treatment in sharps container approved by health Canada .

The foot care nurse has knowledge and skills in the operation of various corn remover tools to remove seeded, hard and soft corn.

Operation of common foot care tools including: ingrown scissors, blacks files, debris evacuator, diamond deb files, nail nippers.
Practice best practice infection control for foot care tools and treatment as per IPAC Canada Reprocessing of critical foot care tools . Practice evidence based use of topical products to decrease formation of callus that is safe on diabetics and non diabetic clients.
Use evidence based product to treat fungal nails in high risk clients. Health teach and provide access and refer clients as necessary for treatment that is beyond the scope of the foot care nurse practice such as matricectomy.
​Documentation and reporting using the nursing process.

Many foot care nurses work in private practice, diabetic clinic and various health care settings. Some may work as service providers for Veteran Affairs to provide foot care service to Veteran. This coverage is often paid by Blue Cross insurance company. 

Some foot care nurses may partner with physicians in their communities, in that they collaborate and work as a team member in providing the foot care treatment for high risk client including the geriatric and the diabetic clients. As the service is covered by OHIP, in this context the physician bills OHIP as the physician has an OHIP billing number for nursing foot care services rendered. 

Nurses who practice Basic and Advanced Nursing Foot care treatment who have completed a Basic and Advanced Nursing foot care program that integrated nursing best practices for foot care, best practice regarding infection control, and using safe foot care tools as per the certification board may qualify as a Certified Foot Care Nurse - CFCN with Foot care Nurse Certification Board.