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To evaluate the effectiveness of a foot self-management strategy that utilized a commercially-available infrared thermometer (CAIT) for prevention of diabetic foot ulcers. In this six-month pilot randomized controlled trial, Phase 2 of a three-phase mixed methods research study, 62 participants were randomized to a thermometer and education group (n = 34) and an education-only group (n = 26). Both groups received foot care education and were assessed by a certified orthotist. All participants recorded their number of steps and recorded a foot assessment in a logbook daily. The thermometer and education group also recorded their daily temperature assessment. A temperature difference of >4° Fahrenheit (F) between the two feet prompted participants to rest their feet. Participants were directed to see their healthcare provider if the temperature difference did not decrease to below 4° F in two days. Phase 3 of the study explored the Phase 2 results to understand the findings further. The strategy improved foot assessment and action: the thermometer and education group had significantly more days with any assessment completed than the education-only group (150.98/180 vs. 119.84/180, p = 0.02). Phase 3 findings showed that the thermometer engaged participants, prompted action, and offered reassurance regarding foot health. A CAIT is a tool that could support foot self-management and may offer several benefits, such as promoting and providing structure for a foot assessment and direction for action. NCT0306776 clinicaltrials.gov. • Monitoring of foot temperature with a medical-grade thermometer is a strategy to help patients identify inflammation that could lead to an ulcer. • We wanted to ask whether daily temperature monitoring with a low-cost commercially available infrared thermometer supports self-management. • We found that the strategy engaged patients, improved foot assessment, and prompted action to address foot concerns. • The low-cost commercially available thermometer is a tool that could support foot self-management and prevent foot ulcers. [ABSTRACT FROM AUTHOR]

Background: High nursing workload, negative role models, and inconvenient location of alcohol-based hand-rub dispensers are among the most common barriers that prevent nursing students and nurses from adhering to Routine Practices (RP). The aim of this study was to identify if nursing students and instructors encountered these three barriers, what strategies they used to address them, and how confident they were about applying problem solving in addressing them. Method: A cross-sectional survey was conducted in three nursing schools in Eastern Canada, and included 577 undergraduate nursing students, and 20 nursing instructors. Data were collected using the Routine Practices Problem-Solving Questionnaire. Frequency distributions were used to describe the participants' characteristics and each item in the questionnaire. Pearson chi-square test was used to assess relationships between the level of confidence and participants' characteristics. Results: We found that only 25% to 44.2% of students and instructors reported that high nursing workload, negative role models, and inconvenient location of alcohol- based hand rub were among the most common barriers which prevented them from adhering to Routine Practices. Although they encountered these three barriers, only 21.1% to 30.2% of students indicated that they used problem solving to address them. However, both groups of participants identified other strategies that can be used to address these three barriers. More instructors, compared to students, were very confident/confident about applying problem solving to address these barriers. There was a significant association between nursing students' levels of confidence and their training in RP as well as their training in problem solving related to RP (p< .0001), but no significant association between the instructors' level of confidence and these characteristics (p > 0.05). Conclusion: Understanding of these three barriers, and knowing possible strategies to address them, including problem solving, can potentially help infection control practitioners in their discussions with nurses, students, and instructors to improve adherence to RP. [ABSTRACT FROM AUTHOR]