title: Evidence of the importance of specialist nursing care dealing with patients with feet at risk of tissue damage. Possible implications for reforms of NHS hospital care?
abstract: Recent media attention has highlighted recommendations from 'Future hospital: caring for medical patients' about specialist medical care being less ward-based. This article gives evidence of the value of specialist nursing in a particular patient group. Here we present data regarding foot care for patients on vascular surgical wards. Ward B recently started to regularly care for vascular patients prior to this study, whereas ward A was previously the only specialised vascular ward in the hospital. All patients on the wards were surveyed on 3 occasions and it was recorded whether each patient's feet were touching the bed footplate. 52% of patients on ward B vs. 23% of patients on ward A had their feet touching the end of the bed (p = 0.03, n = 57). After an intervention of targeted training, alterations to routine manual handling training, and monitoring by matrons, repeat data collection took place. Only 18% of patients on ward B had their feet touching the end of the bed post intervention (p = 0.03). There was no statistical difference between wards post intervention. While looking at a simple, but nonetheless important, aspect of patient care; this audit provides evidence of the importance that nursing staff are familiar with the challenges posed by a particular patient group. If plans for specialised medical care to work across the hospital come to fruition, some patients may be nursed by staff less familiar with their needs. Vigilance and training interventions are likely to be needed for developing problems.
authors.affiliation: Plymouth Hospitals NHS Trust, United Kingdom. Electronic address: d.radley@nhs.net.
authors.forename: David
authors.initials: D
authors.lastname: Radley
mesh_terms: D018409:Foot Injuries / Q000517:prevention & control*; D006801:Humans; D009731:Nursing Audit; D009732:Nursing Care / Q000379:methods*; D003668:Pressure Ulcer / Q000517:prevention & control; D013222:State Medicine / Q000592:standards
keywords: Expertise; Foot; Nursing; Pressure