• Fingernails and toenails require special care to avoid pain and infection, and to maintain personal appearance and mobility

• Referral to the Trust Podiatry Service may be required in certain conditions

• Mental capacity should be assessed and informed consent obtained before the procedure

• Staff must understand individual risks before beginning the procedure

• Correct equipment must be used

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Printed copies must be destroyed after use.

1.1 Patients’ nails require special care in order to prevent pain and infection, and to help to maintain a good personal appearance. They should be kept short, neat and clean.

1.2 Mental capacity must be considered and informed consent obtained before beginning the procedure.

1.3 Extra caution must be used with patients at risk of bleeding, healing delay or with sensory issues.

1.4 For new staff, it would be good practice to assess their competency for this task to ensure they can safely use nail clippers and understand individual risks.

2.1 Extra caution should be used with patients who may be receiving anticoagulant therapy, have delayed healing times, or sensory issues such as neuropathy and hypersensitivity to touch.

For patients with these existing foot conditions, a podiatry referral will be required:

• Distorted nails
• Ingrowing toenail (IGTN) with infection
• High risk Diabetic foot
• Neuro-ischaemic foot

2.2 Nail care must be included in any plan of care, detailing whether the person can maintain their own nail care, whether family support can be provided or whether staff may need to assist them.

3.1 Nail clippers are recommended for the trimming of fingernails and emery boards for filing, to prevent jagged edges.

3.2 Patients should be encouraged to supply their own nail clippers, files and brushes

3.3 A manicure set can be provided by the Trust, ordered via Eros. This must be for single patient use only.

MRA257 PTP33 Manicure set Containing tweezers clippers and emery board (PACK of 10)

4.1 Explain procedure to the patient and obtain their consent.

4.2 Perform hand hygiene, put on non-sterile gloves and apron.

4.3 Prepare equipment, including a bowl of warm water, paper towel and a sharps bin if needed.

4.4 Ensure you and the patient are positioned comfortably.

4.5 Help the patient to wash their hands/feet to soften nails.

4.6 Clip each nail to the top level of the finger/toe, shaping edges with an emery board.

4.7 After completion, dry the hands/feet, apply moisturiser if needed, then leave the patient comfortable.

4.8 Dispose of hospital-supplied clippers in the sharps bin, gather the paper towel and clippings within it and dispose of it in clinical waste bag with apron and gloves.

4.9 Perform hand hygiene. Report any concerns to nurse in charge. Document procedure.