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Assess the feet of individuals with diabetes and provide advice on maintaining healthy feet and managing foot problems

URN: SFHDiabHA4
Business Sectors (Suites): Diabetes
Developed by: Skills for Health
Approved on: 2021

Overview

​This standard concerns assessing the condition of the feet of an individual with diabetes to determine risk status, and taking the appropriate action, which may include a referral for treatment, providing advice, or negotiating a care plan. The individual may be accompanied by a carer, who should be included in the discussions if the individual chooses to involve them.

The activities described in this standard may follow a referral from a preliminary examination or may be a first examination of the feet. The use of a hand-held Doppler to assess blood flow is not included in this standard.

Performance criteria

You must be able to:

  1. access and accurately interpret all relevant work instructions and information
  2. work safely at all times and in accordance with all relevant legislation, guidelines, policies, procedures and protocols
  3. deal promptly and effectively with any problems within your control and report those which cannot be solved
  4. identify and minimise hazards and risk in the workplace
  5. communicate with the individual and key people at a pace, in a manner and at a level appropriate to the individual's understanding, preferences and needs
  6. respect the individual's rights and wishes relating to their privacy, beliefs, and dignity
  7. communicate with individuals and carers throughout the discussion and examination in a manner which is appropriate to them and which encourages an open exchange of views and information
  8. gain valid, informed consent from the individual in accordance with specific procedures

  9. ensure that the individual understands: 

    • the potential effects of diabetes on vascular and neurological problems in the feet and lower legs
    • problems or risks revealed by the examination, including any areas of uncertainty which may require further tests
    • how they can manage their diabetes to maintain the health of their feet

  10. gather information, through discussion with the individual and carer on:


* <span style="font-size:14.6667px;">relevant medical history</span>
* <span style="font-size:14.6667px;">any subjective symptoms of problems in the feet and lower legs

  1. examine and assess the individual for:


* <span style="font-size:14.6667px;">the skin condition of the feet and lower legs</span>
* <span style="font-size:14.6667px;">sensory neuropathy using appropriate tools</span>
* <span style="font-size:14.6667px;">any current infection and ulceration</span>
* <span style="font-size:14.6667px;">any foot deformities</span>
* <span style="font-size:14.6667px;">vascular status for the presence of peripheral arterial disease by palpating pedal pulses</span>
* <span style="font-size:14.6667px;">joint mobility and identify any biomechanical problems

  1. examine the individual's footwear and assess its suitability for foot type and risk status
  2. identify the factors that are likely to affect the individual's ability to care for their feet, and make an overall assessment of their ability to self-care
  3. arrange for further examination or treatment, with appropriate speed, where this is indicated by your risk assessment
  4. negotiate and agree one or more actions that the individual and carer will undertake to address problems or risks
  5. offer written information on footcare in a suitable form for the individual and carer to reinforce their understanding
  6. agree when the individual will next come for examination, leaving an interval appropriate to the risks you have identified 
  7. complete and store all relevant documentation in accordance with organisational requirements

Knowledge and Understanding

You need to know and understand:

  1. the current legislation, guidelines, policies, procedures and protocols which are relevant to your work practice and to which you must adhere
  2. the scope and limitations of your own competence, responsibilities and accountability as it applies to your job role
  3. how to access and interpret all relevant work instructions and information
  4. specific procedures for reporting issues which are beyond your competence, responsibilities and accountability
  5. the duty to report any acts or omissions that could be unsafe/detrimental to you or others
  6. the hazards and risks which may arise during the execution of your work role and how you can minimise these
  7. how to adapt communication styles in ways which are appropriate to the needs of the individual  
  8. the correct use of any equipment and PPE to protect the health and safety of you and others
  9. evidence-based practice and its role in improving care
  10. the principles, practice and procedures associated with informed consent
  11. the needs of individuals and carers including issues relating to dignity, confidentiality, and privacy
  12. organisational management structures, roles, and responsibilities
  13. the procedures and methods relating to the coordination of inter-disciplinary and multi-disciplinary teams within and across services
  14. diabetes monitoring, management and education
  15. prevention and management of foot problems for people with Type 2 Diabetes
  16. causes, signs and symptoms of diabetes
  17. normal and abnormal blood glucose and HbA1c values
  18. typical progressive patterns of diabetes
  19. the importance and effects of individual education and self-management
  20. the psychological impact of diabetes, at diagnosis and in the long term
  21. the social, cultural and economic background of the individual/carer group
  22. the effects of:

```
* smoking, alcohol and illicit drugs

  • intercurrent illness

  • nutrition and physical exercise
    ```

    1. how to manage hypoglycemia
    2. the medications used to manage diabetes
    3. the long-term complications of diabetes and when they are likely to occur
    4. how to examine feet and assess risk status
    5. how to monitor:


* <span style="font-size:14.6667px;">cardiovascular risk</span>
* <span style="font-size:14.6667px;">renal disease</span>
* <span style="font-size:14.6667px;">diabetic retinopathy</span>
* <span style="font-size:14.6667px;">glucose levels, HbA1c, blood pressure

  1. the law and good practice guidelines on consent
  2. referral pathways
  3. quality assurance systems
  4. the process of notification for legal and insurance purposes
  5. sources of practitioner and individual information on diabetes
  6. contact details of local and national support groups
  7. how individuals can access local facilities for exercise and physical activity, education and community activities
  8. how to complete and safely store all relevant documentation in accordance with organisational requirements

Scope/range

Scope Performance

Scope Knowledge

Values

Behaviours

Skills

Glossary

Links To Other NOS

External Links

Version Number

2

Indicative Review Date

2026

Validity

Current

Status

Original

Originating Organisation

Skills for Health

Original URN

HA4

Relevant Occupations

Health and Social Care, Health and Social Services Officers, Health Associate Professionals, Health Professionals, Health, Public Services and Care, Healthcare and Related Personal Services

SOC Code

2259

Keywords

Diabetes; feet; foot; assess; problems; manage