Ballarat Foot Care Project
Background:
Elderly people and people with a disability are recognised as a vulnerable group within the community with higher prevalence of foot problems (Barr et al 2005, Menz 2001). Factors that may contribute to poor foot care may include a lack of awareness of what they can do to care for their feet to prevent problems or limited ability to undertake basic foot care activities due to poor eye sight or flexibility (LaTrobe 2012). The implications of poor foot care can result in reduced mobility and increased risk of falls and complications which require medical intervention (Menz et al 2005).
Community Care Workers (CCWs) are a vital part of the care provision team, providing support and everyday care to these target populations. They are front-line care providers, assisting with basic hygiene, cleaning, transport and other activities of daily living (ADLs), often seeing the client multiple times a week. They often have strong rapport with their clients and through enabling the client to continue to live in their own home by assisting with ADLs, they help to empower the client. This clearly embodies the paradigms underpinning the active service model.
Ballarat Community Health (BCH), Ballarat District Nursing & Healthcare (BDNH), City of Ballarat along with Grampians Regional HACC identified the need to work together to promote better foot care of clients within the City of Ballarat receiving support from Community Care Workers (CCWs). This project was initiated and supported with funding from the Implementation of Allied Health Assistant project (April 2013-April 2014) through the Grampians Region Department of Health.
Project Aim:
To increase the capacity of Community Care Workers (CCW) at the City of Ballarat to:
- Support the independence of clients to look after their own foot health
- Undertake a foot screening and refer (via their assessment officer) as necessary to podiatrist
Method:
To develop and implement education sessions and resources to enable community care workers to:
- undertake discussions with their clients about foot care so as to identify foot care activities the client could undertake for themselves
- to monitor clients foot care and report any concerns to their supervisor/assessment officer as they arise
- to provide basic foot care as directed by the podiatrist/health professional
To set up referral and feedback pathways between podiatry services at BCH and BDNH and the City of Ballarat Community Care Services.
Two one hour education sessions were developed and facilitated by podiatrists from both BCH and BDNH. These sessions were held four times over May 2014 and then July as part of the four CCW teams at monthly meetings. A copy of the training presentation is available on request from BDNH and BCH.
The resources developed included:
Foot Care tips for CCWs to use with clients and personally
Role of CCW in foot health’ handout to ensure CCW were clear of their roles and responsibilities
Screening tool to support CCWs to identify if client needs to be referred to a podiatrist
Podiatrist referral pathway to support City of Ballarat CCW and assessment officers to refer to podiatrist and support feedback between agencies to support coordinated care
Podiatrist referral tool to allow podiatrist to request specific foot care support from personal care providers
Evaluation of training: Pre education survey Post education survey
Training Package – same package used for delivery of training to whole of region (apart from Northern Grampians)
Resources were developed and adapted from a range of sources within the Wimmera, Grampians Pyrenees and Central Highlands catchments. In particular we would like to acknowledge the work of Northern Grampians Shire Council Pilot Foot Care Program for the development of the handout “Client Managed Foot Care – Role of Community Care Workers” and the “Foot Care Screening Tool”.
Further developments:
The Ballarat Project team podiatrists are also providing Foot Care training to the Shires of Pyrenees and Golden Plains.
A copy of the final project report will be uploaded to this website when the project concludes.