Who can perform a foot screening?

The Australian National Guidelines (2011) and the International Working Group on the Diabetic Foot (2019) indicate that any adequately trained healthcare professional may perform a foot risk screening. Within each state, foot risk screening will be delivered by various health care professionals based on resources available.

Therefore in this context, podiatrists will not be the only clinicians to provide foot risk screening exclusively. Healthcare professionals may include general practitioners, nurses, diabetes educators, Aboriginal health practitioners, Aboriginal health workers, allied health professionals and allied health assistants.

How long does a foot screening take?

Foot risk screening (which may occur during an annual diabetes cycle of care) should only take three to five minutes. It provides and informs ongoing management to support and prevent adverse outcomes.

A foot risk screening comprises of four components:

  1. Taking a patient history,
  2. Doing a physical assessment,
  3. Determining risk of developing foot disease, and
  4. Enacting a foot action plan.

The Foot Forward e-learning modules can provide you with the information you need:

Health Professional Login

 

What is a High Risk Foot Service (iHRFS)?

An interdisciplinary High-Risk Foot Service is a specialised  team of health care professionals for people with active foot disease, such as:

  • Foot ulceration (infection, ulceration or destruction of tissues of the foot associated with neuropathy and/or peripheral artery disease in the lower extremity of a person with (a history of) diabetes mellitus)
  • Charcot Foot (non-infectious destruction of bone and joint(s) associated with neuropathy, which, in the acute phase, is associated with signs of inflammation)
  • Osteomyelitis (infection of the bone)
  • Cellulitis (infection of the skin and underlying fat)
  • Gangrene (tissue becomes black because there is inadequate blood flow)

The iHRFS team may comprise Podiatrists, Endocrinologists, Orthopaedic and Vascular surgeons, Diabetes Educators, Clinical Psychologists, Occupational Therapists, Dieticians, Aboriginal Health Workers and Nursing Staff. It uses evidence-based assessment and management for patients with diabetes-related foot complications, aiming to reduce amputations rates, reduce the length of stay (the amount of time you have to stay in hospital) through the appropriate use of hospital investigations and resources.

Follow the link to the Active Foot Disease Pathway

What is a NADC accredited iHRFS?

The National Association of Diabetes Centres – Foot Collaborative developed standards and accreditation for Diabetes High Risk Foot Services(HRFS) is the only national accreditation of its kind, aimed at the improvement of quality and safety in the care of people with diabetes-related foot disease. The accreditation model is focused on a three-pronged approach, combining governance, clinical and quality criteria. The objective of the NADC HRFS accreditation is to assist services to achieve quality patient care through improved interdisciplinary team-based practice that includes improved governance and centre structure, also providing opportunities for clinician education and research.

How does service find out more information on NADC's iHRFS standards and accreditation?

For NADC Interdisciplinary High Risk Foot Service standards and accreditation information Click Here

Any further questions in regard to the process can be emailed to [email protected]

How do I refer to a podiatrist?

Private Sector:

Podiatrists do not need a referral for their services, unless the Chronic Care Management Plan is being utilised.

Public Sector:

Preventative podiatry services are available in each state, but as state and territory governments manage the funding, they vary in whom is entitled to services and they may have specific intake criteria that dictate eligibility criteria.

Note:

Within services there are different eligibility rules, and some schemes require a referral (Chronic Care Management Plan – Medicare) or are offered as part of an aged care package (www.myagedcare.gov.au) or through the National Disability Insurance Scheme (NDIS)

Where can I learn or up skill in foot risk screening?

Foot Forward has developed a comprehensive, integrated foot risk screening e-learning package to standardise foot risk screening undertaken by healthcare professionals.

Target Audience

Diabetes foot risk screening may be carried out by any health care professional/worker involved in the care of people with diabetes. These may include:

  • General practitioner
  • Nurse
  • Podiatrist
  • Orthotist
  • Pedorthotist
  • Aboriginal and Torres Strait Islander health practitioner
  • Aboriginal and Torres Strait Islander healthcare worker
  • Allied Health Assistant

The Foot Forward e-learning foot screening package is cost-free. Follow the link to register: Health Professional Login

The Integrated foot pathway does not reflect my local area – can I adapt it?

Yes, you can adapt the Integrated Diabetes Foot Care Pathway to reflect your local pathways.

Services to assist in your clinical practice

Are you putting your best foot forward? Check your risk level today.

Foot health check takes approx 2 mins