In his lecture at the Midwest Podiatry Conference, Robert G. Smith, DPM, MSc, RPh, FNAP shared “Essentials of Infection Control Practice for the Podiatric Physician.” We had the chance to speak with him about the topic and what he thinks DPMs should know today.

Why is infection control so important in a podiatric practice?

Podiatric physicians must make infection prevention a priority in any setting in which care is delivered. Health care professionals are responsible for monitoring the performance of all their personnel, licensed or not, under their control regarding infection control techniques. Not only are there professional consequences for failure to do so, but it puts us the provider, as well as our staff and our patients at risk for adverse health outcomes. Currently, there are states now that mandate infection control CME as part of their license renewal process.

What are some resources that DPMs can seek out to learn more about infection control and mitigation strategies?

There is an excellent article in the Journal of the American Podiatric Medical Association¹,in which the investigators proposed that infection prevention and control in the podiatric medical setting not only has its challenges, but that there are solutions out there for consistent, safe care.

Further, there are guides to infection prevention for the outpatient podiatry setting developed by the CDC, including an 89-page downloadable manual,² as well as a nice little pocket guide³ that we can give to our staff members that's only 8 pages. This guide has evidence-based findings that allow us to create fundamental components of standard infection precautions in our practices. Some specific topics include: education and training hand hygiene practices, personal protective equipment, safe injection and medication management, as well as environmental cleaning and disinfecting.

What are the first steps that a DPM can take today in crafting or improving their infection control policies and practices?

Well, first of all, a facility risk assessment is a very important key role that we as pediatric physicians can orchestrate, develop, and create. So, the first step is to do an inventory, creating a list of services, procedures, and practices done in our office setting and then assess our facility’s current programming practices. Based on our risk assessment and taking into consideration the types of services provided by the facility and the patient population, then we can prioritize our resources and focus extra attention on areas determined to pose greater risk for our patient population.

Other things that we can do is ensure that at least one individual trained in infection prevention is a regular employee and is available to manage the infection protection control manual and program, including ensuring availability of sufficient and appropriate supplies necessary to adhere to standard precautions.

We need to develop written infection prevention policies and procedures appropriate for the service provided by our facility and based upon evidence-based guidelines, regulations, and standards. But, we must remember that we need to reassess our policies and procedures at least annually and, as I mentioned before, some states now require that we do so.

It is imperative for podiatrists to develop a system for early detection and management of potential infectious encounters, including those from staff or patients. We can identify and triage patients and visitors in a timely fashion to keep everyone that walks through our doors safe.

Dr. Smith is a practicing podiatrist and pharmacist in Ormond Beach, FL. He is a frequent author and lecturer on opioid mitigation, infection control and other foot and ankle topics.

References

1.     Wise ME, Bancroft E, Clement EJ. Infection prevention and control in the podiatric medical setting. Challenges to providing consistently safe care. J Am Podiatr Med Assoc. 2015;105(3):264-272.

2.     Centers for Disease Control and Prevention. Guide to Infection Prevention in Outpatient Podiatry Settings. Available at: https://www.cdc.gov/infectioncontrol/pdf/Podiatry-Guide_508.pdf . Accessed March 28, 2022.

3.     Centers for Disease Control and Prevention. Prevention patient infections. My pocket guide. Available at: https://www.cdc.gov/infectioncontrol/pdf/Pocket-Podiatry-Guide_508.pdf . Accessed March 28, 2022.