Nurses' Awareness and Observational Ability Regarding Toenail Assessment in Older Adults: A Cross-Sectional Study

Toenail disorders (eg, onychomycosis) are common among older adults and may cause pain, impaired mobility, and reduced quality of life. Despite aiding early detection and management, toenail observation is often overlooked in nursing. This cross-sectional survey included registered nurses at a single hospital without specialized foot care training. Associations between case-based observational performance and reasons for not routinely observing toenails were examined using the Mann-Whitney U test. Among 28 respondents, 25 (89.2%) reported that they "sometimes did not" or "did not" routinely observe patients' toenails. Median observational performance and reporting judgment were 60.0% (interquartile range: 43.4-80.0) and 56.7% (20.0-80.0), respectively. The most common reasons were the absence of habitual toenail observation and no prior consideration of toenail care; nurses selecting these reasons had lower observational performance. Routine toenail observation was uncommon and related to these factors.