Background to the implementation of the podiatry assistant role
Service users and the consumer group
Allied Health managers, nursing managers and podiatrists
· Exploration of their use of the service
· Exploration of their service
· Background to their role in foot-care
· Exploration of their service
· Exploration of their interface with the podiatrist and trainee PA
· Why podiatry assistants were introduced
· How their role differs to the PA role
· Their background before training as a PA
· General feelings about the use of assistants
· The impact of the introduction of the assistant on their role, workload, patient throughput (etc.)
· How the PA role was introduced
· What attracted them to the role
· Relationship to and with the new PA
· Why the (PA) role was introduced
· Understanding of, and preferences for levels of training of Pas
· he impact of the PA on their role and their service
· Their training background (including traineeship)
· Important qualities of PAs
· Relationship with the PA
· Mechanisms that help/hinder the new role to be effective
· Mechanisms that help/hinder them to be effective in the new role
· Understanding of the supervision support
· How is it decided what roles/duties they undertake in their service
· Issues that have arisen with the new role
· Current and other possible ways to measure the PA’s effectiveness
· Relationship with qualified practitioners (delegation of roles, autonomy, responsibility)
· Effectiveness of the implementation process
· Mechanisms that help/hinder the PA to be effective
· Supervision arrangements
· Career development opportunities
· Decisions around roles/duties undertaken
· How the PA workload is determined (role boundaries)
· The implementation of the podiatry assistant role in podiatry/why the role was introduced
· Traineeship model
· The roles and responsibilities of the podiatry assistant (scope of practice)
· What makes a good podiatry assistant?
· Negotiation of roles
· Supervision and support structures
· Factors that facilitated the introduction of the podiatry assistant role
· Barriers to the introduction/opposition to new role
· Impact/defining and measuring success
· Development opportunities for the role/Career development opportunities
· Service user perspectives on the role
Why the role was introduced
Roles and Responsibilities
Scope of practice
The following tasks must not be included in a podiatry assistant’s scope of practice under any circumstances:
Clinical interpretation of podiatry referrals
Interpretation of a patient’s diagnosis or prognosis
Interpretation of assessment findings
Development of a physical diagnosis
Development or modification of a patient’s treatment or care plan
Clinical advice outside the parameters of an approved care plan or standardised general health promotion information
Casting for custom orthoses
Moulding of prefabricated or non-casted mouldable orthoses
Clinical evaluation or review of treatment modalities
Clinical treatment involving the use of a scalpel
Injections and/or surgical procedures
l) Clinical assessment or examination of patients including:
-Biomechanical(including postural or gait assessments)
A registered podiatrist is at all times professionally responsible for a patient’s care plan and treatment, the podiatry assistant, their scope of practice and conduct whilst being directly accountable for the care a patient receives. The podiatrist must be familiar with and work within the Podiatry Board of Australia Guidelines for podiatrists working with podiatric assistants in podiatry practice.
The registered podiatrist must ensure the following:
All patients have an initial assessment completed and an appropriate care plan recorded prior to involving an assistant in any treatment.
The care plan clearly delineates the treatment that will fall within the appropriate scope of practice for the assistant.
The patient is reassessed and their care plan renewed annually.
The podiatry assistant has the required minimum qualifications, training and competencies to complete the delegated tasks.
A podiatry assistant is at no time delegated tasks outside their scope of practice or for which they have not yet been deemed competent or not safe to perform particularly when they undertaking training.
All warning and safety procedures are undertaken with patients including instructions regarding contraindications, adverse reactions and expected reactions of the techniques to be applied.
The podiatry assistant fully understands and can implement the process for reporting both clinical and non-clinical emergencies.
Where a podiatry assistant is working without direct supervision and a clinical emergency occurs documented protocols exist that specify the process for reporting unexpected changes to a patient’s health or foot care needs.
A podiatry assistant is at all times clearly and correctly identified as an assistant. A referral may only occur once discussed with a patient and informed consent obtained.
A podiatry assistant is provided with clear directions of the work to be undertaken.
Clearly defined lines of communication and direction are established and the assistant is aware of these.
The quality of work completed by the assistant is regularly evaluated to ensure they are working in a competent and safe manner.
Developing and defining scope of practice
Supervision and support structures
Negotiation of roles
The traineeship model
Impact of the new role
Perceived impact of the role
Facilitators and barriers to successful implementation
Process reusable instruments and equipment in health work
Assist with podiatry assessment and exercise
Assist with podiatric procedures
Assist with basic foot hygiene
Explain to the client the purpose, rationale and requirements of the foot hygiene session
Determine the client’s understanding of the purpose, rationale and requirements of each part of the foot hygiene session
Identify any condition indicating the client is at high risk that requires podiatrist attention
Assist client in and out of shoes, socks and hosiery where necessary
Correctly position the client prior to foot hygiene session
Implement necessary infection control measures
Perform basic foot hygiene according to the directions of the podiatrist and using appropriate infection control precautions, especially in relation to air borne particles
Apply appropriate dressings to any skin breaks which might result from treatment
Provide feedback that reinforces the podiatrist’s advice
Identify and manage client compliance issues.
Work with client to determine and plan any follow up requirements and dates
Seek assistance when client presents with needs or signs outside limits of own authority
Report client difficulties to the supervising podiatrist