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Here are resources to help you understand and comply with appropriate infection control protocols and guidelines for "routine" foot care.

Infection Control Standards

Evidence-Based Guidelines for Safe Foot Care Practice

AFCNA Infection Control Standards for Foot Care Professionals

 

The American Foot Care Nurses Association (AFCNA) establishes evidence-based infection prevention standards to ensure safe, high-quality foot care across all practice settings. These guidelines align with current CDC and FDA recommendations and reflect global best practices in nursing and podiatric infection control.

Purpose

The purpose of these standards is to provide consistent, evidence-based guidance for infection prevention in professional foot care, protecting patients, providers, and healthcare environments.

1. Core Principles of Infection Prevention in Foot Care

Foot care involves close contact with skin, nails, and potential bio-burden. Infection prevention protects:

  • Patients

  • Providers

  • Community environments

  • Healthcare systems

All foot-care professionals are required to follow the four levels of decontamination.

 

2. Levels of Decontamination

Cleaning

  • Removes visible soil, organic matter, and debris

  • Uses water, detergents, and mechanical friction

  • Required before any disinfection or sterilization

 

Sanitizing

  • Reduces microbial contamination to public-health–defined safe levels

  • Used for non-critical surfaces

  • Does not replace disinfection or sterilization

 

Disinfecting

  • Destroys most pathogenic microorganisms (bacteria, viruses, fungi)

  • Does not reliably eliminate spores

  • Required for semi-critical instruments contacting intact skin

 

Sterilizing

  • Eliminates all microbial life, including spores

  • Required for critical instruments contacting non-intact skin or penetrating tissue

  • Achieved via:

    • Steam autoclave

    • Gas sterilization

    • FDA-cleared liquid chemical sterilant

 

3. Instrument Reprocessing Standards

Step 1 — Pre-Cleaning

  • Remove visible debris immediately after use

  • Use enzymatic or neutral pH detergent

 

Step 2 — Cleaning

  • Manual or ultrasonic cleaning

  • Rinse thoroughly

 

Step 3 — Disinfection or Sterilization

  • Critical instruments: must be sterilized

  • Semi-critical instruments: high-level disinfection or sterilization

  • Non-critical items: low-level disinfection

 

Step 4 — Storage

  • Store sterilized instruments in clean, dry, closed cabinets

  • Maintain package integrity

 

4. Environmental Cleaning Standards

Between Each Client

  • Clean and disinfect treatment surfaces

  • Replace linens or disposable barriers

  • Perform hand hygiene

 

Daily

  • Clean floors, chairs, carts, and high-touch surfaces

 

Weekly

  • Deep clean all equipment and storage areas

 

5. Hand Hygiene & PPE

Hand Hygiene

  • Before and after every client

  • After glove removal

  • After contact with contaminated surfaces

 

PPE Requirements

  • Gloves for all foot-care procedures

  • Masks when aerosolization or dust is possible

  • Eye protection when splash risk exists

 

6. Regulatory Framework

CDC

  • Guideline for Disinfection and Sterilization in Healthcare Facilities (2008)

  • Updated June 2024

  • Provides scientific evidence and recommended practices

 

FDA

  • Regulates liquid chemical sterilants and high-level disinfectants

  • Maintains list of FDA-cleared sterilants

Content current as of November 30, 2023

 

7. Evidence Standards

AFCNA applies the following hierarchy of evidence:

 

Tier 1 — Highest Quality

  • CDC

  • FDA

  • WHO

  • Peer-reviewed systematic reviews

  • National regulatory bodies

 

Tier 2 — Acceptable Supporting Evidence

  • Professional nursing associations

  • Specialty foot-care organizations

  • Manufacturer Instructions for Use (IFUs)

 

Tier 3 — Not Acceptable

  • Blogs

  • Commercial marketing materials

  • Non-peer-reviewed content

 

8. Governance & Annual Review

Responsible Party

  • AFCNA Infection Control Committee Chair

 

Review Cycle

  • Annual evidence review

  • Update CDC and FDA references

  • Review WHO and international guidelines

  • Submit revisions to AFCNA Board

  • Publish updated version

 

Version Control

  • Current Version: 2026

  • Next Review: January 2027

 

 

Website Layout Structure (Recommended)

Hero Banner

Headline:
Setting Global Standards for Infection Prevention in Foot Care

Sub-text:
AFCNA provides evidence-based guidelines aligned with CDC, FDA, and international best practices.

Visual:

  • Clean medical background

  • Shield or sterile instrument icon

Four Levels of Decontamination

4-column grid with:

  • Icon

  • Title

  • Short description

Instrument Reprocessing

Step-by-step visual:

  1. Pre-clean

  2. Clean

  3. Disinfect / Sterilize

  4. Store

Environmental Cleaning

Checklist format:

  • Between clients

  • Daily

  • Weekly

Hand Hygiene & PPE

Two-column layout:

  • Left: Hand hygiene steps

  • Right: PPE requirements

Regulatory Framework

Accordion sections:

  • CDC

  • FDA

  • WHO

  • National guidelines

Evidence Standards

Pyramid graphic:

  • Tier 1 → Tier 2 → Tier 3

Governance & Review Cycle

Timeline:

  • Evidence scan

  • Committee review

  • Board approval

  • Publication

Downloadable Resources

Buttons:

  • Infection Control Standards (PDF)

  • Instrument Reprocessing Checklist

  • Environmental Cleaning Protocol

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