As a Registered Nurse (RN) in Ontario, providing foot care in a home care setting is an essential part of helping clients maintain mobility, prevent infections, and improve overall quality of life. Many seniors, individuals with diabetes, and those with mobility challenges rely on skilled nursing foot care to manage conditions such as calluses, ingrown toenails, infections, and circulation issues.
This guide will cover the importance of in-home foot care, best practices for RNs, Ontario regulations, and key tips for ensuring patient safety and comfort.
Why Foot Care Matters in Home Nursing
Foot health is often overlooked, yet it plays a critical role in overall well-being. In-home foot care services help prevent complications, reduce pain, and enhance mobility, particularly for seniors and those with chronic illnesses.
Who Needs In-Home Foot Care?
Registered Nurses providing home care often treat:
Seniors – Aging causes thinner skin, poor circulation, and loss of sensation, making foot injuries more common.
Diabetics – Diabetes increases the risk of foot ulcers, neuropathy, and infections, requiring specialized care.
Individuals with Mobility Issues – Those with arthritis, strokes, or spinal cord injuries may struggle with self-care and need assistance with foot hygiene and nail trimming.
Patients with Circulatory Issues – Conditions like peripheral artery disease (PAD) can lead to foot pain, slow healing, and increased infection risk.
Scope of Practice for RNs Providing Foot Care in Ontario
Registered Nurses in Ontario can assess, treat, and provide preventative foot care as part of their professional duties. However, specialized foot care nurses may require additional training and certification for advanced procedures.
Regulatory Considerations
College of Nurses of Ontario (CNO) Standards – RNs must follow CNO practice standards, ensuring competence, safety, and ethical care in home settings.
Public Health and Safety Requirements – Nurses must maintain infection control protocols to prevent cross-contamination.
Billing & Funding – In-home foot care services may be covered under Ontario Health Insurance Plan (OHIP), private insurance, or paid privately by clients.
Best Practices for In-Home Foot Care Nursing
Conducting a Comprehensive Foot Assessment
Before providing care, an RN should conduct a thorough assessment of the client’s feet, looking for:
Skin integrity (ulcers, wounds, redness, swelling)
Nail health (thickened, fungal, or ingrown nails)
Circulation (temperature, capillary refill, pulses)
Sensation (signs of neuropathy, numbness, tingling)
Pro Tip: Document findings carefully and refer to specialists (e.g., chiropodists, podiatrists) when necessary.
Nail & Skin Care
Proper nail trimming and callus management prevent infections and complications.
Trim nails straight across to prevent ingrown toenails.
Smooth rough edges with a file to reduce skin irritation.
Moisturize dry skin to prevent cracks and ulcers (avoid applying lotion between toes to prevent fungal growth).
Remove thick calluses gently to prevent pressure sores.
Avoid: Cutting nails too short, digging into the sides, or using sharp instruments without proper training.
Diabetic Foot Care
Diabetics are at high risk for foot ulcers and infections due to poor circulation and nerve damage. RNs should:
Inspect feet for cuts, blisters, or pressure sores.
Educate clients on daily foot hygiene and proper footwear.
Monitor for signs of infection, redness, or swelling.
Refer clients to a physician or specialist if wounds are slow-healing.
Wound Prevention & Care
Patients with poor circulation or diabetes often struggle with slow-healing wounds, which can lead to serious infections or amputations if untreated.
Teach clients to check their feet daily for wounds.
Provide proper dressing changes and wound care when needed.
Encourage clients to wear protective, well-fitted footwear.
Infection Control & Safety in Home Care
Since foot care involves skin contact, infection control is crucial.
Always wear gloves and use sterilized instruments.
Disinfect all tools between clients to prevent cross-contamination.
Use disposable nail files and buffers when necessary.
Follow Ontario’s Infection Prevention and Control (IPAC) guidelines.
Challenges & Considerations for Foot Care Nurses
Clients with Poor Circulation & Slow Healing
Patients with diabetes or vascular disease may not feel pain due to nerve damage, making foot injuries go unnoticed. Regular monitoring is key.
Limited Access to Care in Rural Areas
Ontario’s rural communities often have fewer foot care specialists. RNs providing home foot care play a critical role in these regions.
Navigating Client Funding & Coverage
Not all in-home foot care is covered under OHIP, so patients may need private insurance or self-pay options. Providing clear billing information can help manage expectations.
Building a Successful In-Home Foot Care Practice
For RNs looking to specialize in foot care nursing, consider the following:
Get Certified – Advanced foot care courses (e.g., from the Wound, Ostomy and Continence Nursing Canada) can expand your expertise.
Network with Physicians & Podiatrists – Build referral relationships with local doctors and foot specialists.
Offer Mobile Services – Many Ontario nurses run independent foot care businesses, providing care directly to clients in their homes.
Educate Clients – Teach patients how to maintain foot health at home to prevent complications.
Final Thoughts: The Impact of Quality Foot Care
Providing foot care as a Registered Nurse in Ontario’s home care sector is about more than just trimming nails—it’s about preserving mobility, preventing serious health issues, and enhancing quality of life. With the right skills, infection control measures, and patient education, nurses can make a lasting impact on the health and well-being of their clients.
For those considering specializing in foot care nursing, the demand in Ontario is growing, particularly for seniors and diabetics. Whether working with home care agencies, long-term care facilities, or independently, foot care nurses play a critical role in ensuring patients remain active, pain-free, and independent.
Healthy feet lead to a healthier life!