Author Archive

Research Study Reveals Nurses’ Importance in Stoma Care

Wednesday, March 31st, 2021
nurse with patient

The study was conducted by nurses and nurse faculty in Spain at two university hospitals and one public hospital in Spain. Twenty-one adult ostomy patients were asked for their insights before and after their ostomy surgery.

Fourteen of the patients had a gastrointestinal stoma due to cancer, six due to inflammatory bowel disease, and one due to familial polyposis. About 48% of the sample had an ileostomy and 52% had a colostomy. More than half (62%) had a permanent stoma, while 38% had a temporary stoma.

(more…)

State Practice Act Liability Affects All Members of Wound Care Team

Wednesday, November 25th, 2020
state practice act

Potential liability under your state practice act is something to always be aware of.

If you face an alleged violation of your practice act, professional disciplinary action can be initiated by the applicable board that administers and enforces the act.

Disciplinary actions are determined by each professional board such as the board of medicine, board of physical therapy, occupational therapy board, or board of nursing.

Professional disciplinary decisions are public records, and most state boards provide online access to them.

(more…)

Legal Case Highlights Importance of Wound Care Documentation

Wednesday, November 4th, 2020
wound care documentation

We have discussed the importance of nurse expert testimony in cases alleging professional negligence against you.

One blog addressed a breach of your standard of care when providing wound care.

A second reviewed the importance of your wound care documentation in the patient’s medical record.

This article takes a look at the 2016 case, Henson v. Grenada Lake Medical Center, to underscore both of these important points.

(more…)

Hand Hygiene Tips for Providing Wound Care in Challenging Settings

Wednesday, September 16th, 2020
hand hygiene

Hand hygiene is nothing new in healthcare. It has become increasingly important throughout the COVID-19 pandemic.  

As a wound care nurse, you know hand hygiene is essential in preventing infections when providing patient care, as we discuss in the blog post “The Case of the Dirty Wound Care Clinic.”

If you provide care outside of the traditional clinical settings, such as a hospital or a wound care clinic, you know how difficult it can be to maintain good hand hygiene. Without running water, gloves or sanitizer, the risk of infection or its spread is evident. 

(more…)

Nursing Documentation in Wound Care Is a Key Factor in Determining Liability

Thursday, August 13th, 2020
Nursing documentation

The medical record is an essential piece of evidence in any legal case alleging professional negligence against wound care nurses and others.

As you know, one of the purposes of the medical record is to reflect what nursing care was given to the patient. The entries speak to the quality of the care given.

The entries are supplemented by oral testimony at trial of those whose notations are in the medical record. A jury then decides if care was given that meets the standard of care in the situation or if the caregiver failed to meet his or her legal obligation.

The following 2020 legal court decision (Nixon v. The Brookdale Hospital Medical Center, Parkshore Health Care, LLC, Four Seasons Nursing and Rehabilitation Center, and the New York Community Hospital of Brooklyn, Inc.), illustrates the importance of nursing documentation and potential liability for patient injuries and death.

(more…)

Ileal Conduit Care and Nurses: A Review of Evidence-Based Practice

Thursday, July 16th, 2020
ileal conduit

In 2019, researchers in China released an important study on interventions with ileal conduit patients after having undergone surgery for bladder cancer.

It has since proven to be a wonderful resource for all providers who work with ileal conduit patients.

The study began in 2014 with the establishment of a “dedicated team” of ostomy specialists who provided standardized postoperative care.

Its purpose was to undercover the effects of a more involved, systematized program of postoperative care for patients with ileal conduits who were discharged from the hospital.

(more…)

Your State Nurse Practice Act Can Dictate Wound Care Liability

Wednesday, June 17th, 2020
state nurse practice act

I received a question about an RN who was practicing in a “wound center.” 

She received notice from her state board of nursing that a complaint had been filed concerning her treatment of a patient’s wound. 

According to the RN, a substitute physician saw her patient one week. He told the patient and a family member that Tegaderm should not have been used on the wound.

In addition, the substitute physician said there were two wounds — not one — and the second had not been treated.

The RN stressed the following:

  • There was only one wound
  • The substitute doctor was incorrect
  • The patient’s regular physician had been seeing the patient for some time and knew there was only one wound
  • She was upset about the complaint
  • Had to hire an attorney to represent her before the board
  • She believes the physician defamed her and should pay her attorney fees
(more…)

Ability of Patient to Provide Own Ostomy Care Called into Question

Wednesday, May 27th, 2020
ostomy

As a wound care nurse, you teach your patients how to care for their wounds, including a colostomy.

You teach them as they observe treatments you provide, such as ostomy care, while they are at a clinic.

It also includes orally reciting your care as you carry out treatment and direct the patient. This empowers them to understand what is required for appropriate personal care. 

You also might write down instructions and diagrams about required treatment that patients can take home and reference.

The teach-back method of patient instruction incorporates both of these approaches. This is when you have the patient repeat back what you instruct and demonstrate the care you described.

Any patient teaching also requires that the patient comprehend your:

  • Demonstration of care
  • Verbal instructions
  • Ability to carry out the treatment
(more…)

Why Continued Competence in Wound Care Nursing Matters

Wednesday, April 29th, 2020
continued competence

Continued competence in nursing is not a new idea. It has been the focus of professional nursing practice at all levels.

You can find an abundance of information, research and articles on continued competence, whether the topic is:

  • How continued competence is measured
  • How it can be improved
  • How best to increase and maintain competence

One definition of competence is the quality or state of having sufficient knowledge, judgment, skill or strength (as for a particular duty or in a particular respect).

Another definition describes competence as the quality of being competent — adequacy; the possession of required skill, judgment, qualification or capacity.

(more…)

Hyperbaric Oxygen Therapy Case: Liability Can Result from Treatment Inaction

Wednesday, March 25th, 2020
hyperbaric oxygen therapy

Many of you have worked with wound care patients needing antibiotics and hyperbaric oxygen therapy.

In the 2016 Texas case of Gonzalez v. Padilla, the issue of whether the antibiotics or hyperbaric oxygen therapy were properly prescribed was a core issue in the case.

The patient was struck while riding his motorcycle and was taken to a university-based medical center with a broken lower right leg and a de-gloved heel.

An open external fixation procedure of his compound, comminuted fracture was successfully performed and a “halo type” fixation device was placed around the leg to hold the bones in place as the fracture healed.

The patient was also placed on IV antibiotics, including Gentamicin and Cefazonlin for a period of five days. In addition, he received daily wound care treatments.

The medical center’s records indicated his right leg showed “obvious evidence of continued blood flow … and no obvious necrosis beneath the heel tissue itself.”

Read more