Essential tools for the podiatrist

Despite the lack of clear legal regulations created for the podiatry profession, the Polish Podological Society has attempted to define Polish podiatry standards. Below, we present suggestions and recommendations for all podiatry practices in the country. They have been drawn up according to the legal acts in force, as well as based on the standards in force in other European countries and the experience of Polish podiatrists.

Equipment in the podiatry practice
The equipment of a podiatry practice is very important. It is worth investing in equipment that will last for many years and ensure the safety of both the patient and the practitioner. Below, we present suggested equipment for a podiatry practice:

Podiatry chair, preferably electric having a minimum of adjustment: vertical, backrest, so called cradle function, movable split footrests, lifting capacity of at least 120 kg,
Podiatry milling machine (for dry work with an absorber or for wet work, with a maximum speed of not less than 20,000 rpm,
Swivel stool with possible height adjustment, preferably with backrest,
Chair or stool for the patient to rest before and after the procedure, to undress, dress, etc.
Lamp with magnifying glass on a stand or screw-on,
An assistant with drawers or a table to accommodate the milling machine and/or a screw-on loupe lamp when not free-standing and to store hand-held sets of instruments and cosmetics, preparations or other materials used during the procedure, made of washable and chemically and disinfectant-resistant material,
Instruments (a minimum of one set per patient - European standards indicate that there should be 8 such sets per treatment site. In Poland, it is assumed that there should be enough instruments for all patients on a given working day. If there is a break during the working day for sterilisation of instruments, there may be correspondingly fewer sets.

What does the sterilisation package in podiatry contain?
Side forceps,
Straight pliers,
Probe,
Scalpel - disposable blade,
Scalpel handle,
Disposable scalpel (blade + holder)
Chisel - disposable blade,
Handle for chisel,
Anatomical and/or surgical tweezers,
Scissors,
Facet pincers,
Cutters, taking into account the different working techniques - everyone chooses them individually, but a set consisting of at least: a nail plate cutter, a nail roller cutter, a nail plate polisher, a diamond cutter for smoothing the cuticle, for spray cutters or a rubber carrier for sandpaper overlays is recommended.
Foot care preparations,
Specialist dressings,
Ready-to-use pressure relievers or materials for making them,
Of course, a dispenser for hand disinfectant, soap, paper towels and a long shoehorn complete the standard equipment for the treatment station.

Personal protective equipment
Suggested standard for a treatment station in a podiatry practice:
For the practitioner:
Workwear that allows hands to be washed freely, with long sleeves, these must adhere to the body to minimise the possibility of accidental contact with the treatment area,
Work footwear, sturdy, covered, full, holding heel,
Disposable gloves,
Goggles and/or visor,
3-layer dust mask,
Cap.

For the patient:
Disposable towels,
Disposable liners,
Disposable podiatry chair pads or foil pads,
Disposable flip-flops for pedicure,
Foot disinfectant and refresher.

Appliances and equipment are also worth considering:

Ultrasonic cleaner (with basket) or tub (with basket)
Class S autoclave (for B-type loads and optionally A-type for capillary-type loads) or optionally Class B autoclave
First aid kit labelled and positioned in accordance with applicable regulations
Fire extinguishing agents in accordance with regulations, positioned and labelled
Kit for floor cleaning and rapid disinfection (in a separate area) as well as disinfection of the work area: patient chair, instrument handle, cabinet or lamp.

It is advisable to use your own autoclave, preferably in a separate, dedicated room, while observing the requirements for the decontamination line.

If the autoclave is located in a treatment room, it should have the same amount of space as the decontamination line (dirty area, clean area, packaging area, etc.),
If the autoclave is located in the treatment room, the autoclave should not be used during patient handling. It is a good idea to install a separate cupboard for clean clothes and working clothes,
Within the treatment area, both the floors and walls (at least up to a height of 1.6 m) as well as the equipment should be covered with a washable, chemical-resistant material.
A minimum of 6 m2 of total area should be designated for one treatment station. There should be a minimum of 13 m3 of free room volume and a minimum of 2 m2 of free floor space not occupied by technical devices, equipment, etc. for each employee working simultaneously in the room. The height of the room should be a minimum of 3.3 m, but may be reduced to a minimum of 2.5 m. However, in the case of the use of mechanical ventilation, supply and exhaust ventilation or air conditioning, the lowering is subject to the approval of the provincial sanitary inspector. Such approval is obtained upon commissioning of the surgery. Natural and artificial lighting is recommended - at least 1 tilt window.
There should be one treatment station per treatment room - if there are several stations in the room, they should be arranged in such a way as to ensure patient discretion and comfort.
It is necessary to provide access to a WC with a washbasin, with access to the WC not running through the treatment area,
Labelling of medical and communal waste bins and a designated temporary storage area for medical waste is important. A refrigeration unit for temporary storage of medical waste also plays an important role.
What else is necessary before commissioning a podiatry practice?
Sterilisation documentation,
A signed contract with a company for waste collection, including medical waste,
In case of min. In case of employing at least 1 employee - documentation entitled: "Occupational risk assessment",
Compliance with personal data protection requirements (GIODO),
Patient records kept in paper form, now more often in electronic form,
It is recommended that photographic records of therapy are kept,
Installations and equipment are subject to periodic inspection, cleaning and disinfection as recommended by the manufacturer, which is documented each time,

Relevant instructions and procedures:
First aid,
Fire safety.
Use of autoclave including sterilisation procedure,
Hand washing,
Handling infectious material and other waste,
Dealing with work clothing,
Handling of infectious material and other waste, Handling of working clothes, Handling of punctures,
as well as others required by inspection authorities.