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I have a topic that a number of my colleagues and I have been debating at length - whether or not podiatrists can or should use nail drills in a residential aged care facility setting.
We have some hard fast facts about using drills - for compliance with Australian infection control standards, nail drills need vacuum extraction, they need to be used in rooms that have a ventilation/extraction system in place, serious PPE needs to be worn (goggles, FFP1 or FFP2 grade face masks, aprons etc).
We have the logistical standpoint whereby the argument is that the vacuum extraction drills are too heavy and expensive for a mobile podiatrist to cart around in an aged-care setting - and likely too valuable to leave in the care of the facility between visits; using a portable hand-held drill like a Dremel creates the dilemma of not having any dust extraction at all putting both podiatrist and patient at very high risk of inhaling dust particles or having eye and skin irritation; the rooms in which a podiatrist treats in residential aged care are unlikely to have sufficient ventilation let alone an extraction system. All of theses points lead to an OHS/HR stance of "Not safe for the podiatrist, not safe for the residents being treated, ergo not allowed to use drills".
But from the patient-treatment view, can we provide the best standard of care if we cannot provide treatment using a burr/mandril bit with sanding discs? I do know a lot of pods have ace nipper/scalpel/file techniques to battle gryphotic nails and of course scalpel technique learned at university then honed by practice deals with gnarly calluses and corns, however surely having the option of a drill to assist is better for the patients' treatments and for the podiatrists' wellbeing?
We have argued for drills, against drills; from patient, podiatrist and company standpoints... Now we are at an impasse. I want to throw it into the Pod-Arena for further input. I have been through the forum archives and found bits and pieces but they are quite old threads (though most argue against the handheld-no-extraction-drills for good reason) and I was hoping for more up to date advice on current practice from those working in aged care or doing domicilliary rounds. Any and all comments would be greatly appreciated!
Emma
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Biomechanics of the Ageing Foot and Ankle
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Biomechanics of the Ageing Foot and Ankle
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Plantar Pressure Analysis of Accommodative Insole in Older People with Metatarsalgia
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