Archive for the ‘Legal’ Category

Case illustrates importance of clear wound care delegation

Friday, April 12th, 2019

delegation

In the following case, the issue of delegation of wound care was the focus of the case.

wound care

By Nancy J. Brent, MS, JD, RN

A female patient’s doctor ordered home healthcare services after her hospitalization for renal disorders and congestive heart failure. The patient employed a local home healthcare agency to provide skilled nursing care for the patient’s many health problems.

Six months later, the physician discovered his patient had developed four decubitus ulcers, including one on her right hip, which measured 5-1/2 centimeters in diameter and 7-1/2 centimeters deep.

The physician ordered the nurses to clean the wounds regularly and two months after the orders were being carried out, he delegated to the nurses to begin to pack the right hip wound with Betadine gauze.

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Legal issues clinicians should know when taking wound care pictures

Wednesday, April 3rd, 2019

wound care pictures

Regardless of where a wound care professional practices, following the trajectory of a wound is essential to providing the best care.

Carole Jakucs

By Carole Jakucs, MSN, RN, PHN

In addition to measuring wounds, part of today’s practice sometimes includes taking wound care pictures. The steps involved when photographing wounds depends on your organization’s written policies and procedures.

Some healthcare organizations provide computer-based applications and devices that wound care staff are required to use when taking wound care pictures. These photos are typically uploaded into each patient’s electronic medical record.

Other employers may not provide these tools, however. When this occurs, wound care clinicians may be tempted to use their personal cell phones to take wound photos to monitor the success of their care or share with other clinicians for advice.

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What do I need to know about professional liability insurance for nurses?

Tuesday, March 19th, 2019

professional liability insurance for nurses

One of our members submitted a question about what type of professional liability insurance for nurses she should purchase, especially since she is now certified in wound care.

wound care

By Nancy J. Brent, MS, JD, RN

Questions about professional liability insurance are constantly raised by nurses in all areas of nursing practice.

Wound care nurses are no exception, and this topic was briefly covered in on our blog titled Wound Consulting Business: How to Get Started.

There is a great deal of important information for you to know as a wound care nurse before selecting a professional liability policy.

Before discussing that information, it is important to emphasize that as a practicing wound care nurse, you need to purchase your own professional liability insurance policy.

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Wound care specialist has legal concerns when asked about clinical issues ‘on the fly’

Wednesday, March 6th, 2019

wound care specialist

A reader who is the wound care specialist at her facility submitted a question about being approached by wound care clinicians regarding patient care issues when she is in the hallway, at lunch or is leaving the facility for the day.

wound care

By Nancy J. Brent, MS, JD, RN

She wonders how to handle these situations since she knows her “duty” as a wound care specialist starts when clinicians seek a consultation.

She is right to be concerned about evaluating a patient’s wound care at times when she cannot focus on the case.

In a 2013 study analyzing five years of medical malpractice cases, 7,149 out of 23,000 medical claims and lawsuits involved communication failures. Inpatient settings accounted for 44% of the cases, and 9% of the cases involved nurses/nursing. (more…)

The Head to Toe Search for Wounds

Tuesday, June 12th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

A comprehensive skin assessment should look for more than just wounds because many medical problems have telltale signs that are easy to see if you know what to look for.

comprehensive skin assessment

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

POA. These three little letters have become very important in wound care because we must document any wounds present on admission (POA). By doing so, we are saying that these wounds began somewhere else—maybe at home, maybe in another care setting, but definitely not while under the present facility’s care. This distinction of origin has great implications both financially and legally.

 

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The Case of the Dirty Wound Care Clinic

Friday, December 15th, 2017

Nancy Collins, PhD, RDN, LD, NWCC, FAND

We have made progress in reducing healthcare-associated infections, but still have a long way to go, especially when patients complain of dirty, dingy hospitals and clinics.

Dirty Wound Care Clinics and Infections

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

I feel a little like girl detective Nancy Drew as I ask you to consider the Case of the Dirty Wound Care Clinic. Let me explain. In a recent lawsuit, the plaintiff alleged that her mother’s wound did not heal and became infected because of the lack of cleanliness in the hospital-based clinic where she was receiving treatment. It would not surprise me if your initial reaction to this claim is that it is nonsense, so let’s take a closer look.

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Can You Use Job Burnout as a Legal Defense?

Friday, November 10th, 2017

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Wound care is a stressful profession, and sometimes your empathy bucket becomes empty, but job burnout is not a proper professional or legal defense.

Can You Use Job Burnout as a Legal Defense?

 

A group of my professional friends were having lunch together and catching up when one friend disclosed that she was taking a month off of work. We all looked at her agape and at the same time exclaimed “a month?” We had a dozen questions for her. Was she ill? How did she arrange this? What did her supervisor say? Would she still have her job at the end of the month? And most importantly, why was she taking a month off?

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Three Common Reasons You Might Get Sued

Friday, August 11th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Patients often sue for reasons that have nothing to do with the quality of the medical care rendered, but rather for the human care that is perceived as lacking.

Three Common Reasons You Might Get Sued

 

The last few weeks were very difficult for my family and friends in the medical sense. I had one family member in an intensive care unit on the West Coast, one friend’s father in a rehab facility on the East Coast, and one friend’s son having problems in the outpatient setting in the Midwest. These patients are male and female, young and old, and have very different medical histories, but they all have one thing in common. They all want to sue about their medical care or lack thereof. These cases illustrate three common reasons you might get sued. Let’s take a closer look at what has gone wrong for each patient.

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Truth or Consequences: Admitting Your Wound Care Program Needs Improvement

Friday, June 9th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Some healthcare providers are working in underperforming facilities, and they need to discuss how to improve outcomes before it becomes a matter of legal record.

Truth or Consequences: Admitting Your Wound Care Program Needs Improvement

 

“I didn’t have any special training in wounds. No one else wanted to do it, so I said okay.”

“The weekends were really bad. We only had a few people working weekends.”

“I know some of the patients didn’t get turned all day.”

“We always were running out of supplies, so I improvised.”

All of these confessions, or truths, are from real life depositions of nurses who were working in facilities that patients were suing because they developed wounds. These nurses were not trying to hurt their facility in any way or stymie the defense team, but were simply telling the truth in their opinion.

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Nine Wound Care Documentation Pitfalls to Avoid

Friday, May 12th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Lawsuits often are settled out of court because the medical record documentation is not defensible. Incomplete, illogical, and inconsistent records are far too common, so it is important to avoid the common pitfalls.

9 Wound Care Documentation Pitfalls to Avoid

 

After reviewing hundreds of medical charts involved in litigation, I noticed many of the same problems occurring in the wound care documentation over and over again. From New York to Florida to California, it is remarkable how the same inconsistencies, errors, and oversights tend to stymie the defense of a case. The goal of every healthcare practitioner is to have complete, accurate, and timely documentation of the medical care given to each and every patient. Here are nine wound care documentation pitfalls to avoid.

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