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Wound care costs in the United States exceeds 10 times more than that of other countries.1 Legal suites are increasingly paid out by clinicians, not the hospitals or the healthcare system. Many clinicians are facing lawsuits for malpractice or professional neglect. When taken to court and found guilty, the judgment will result in a large settlement then include the loss of the clinician’s license.
OpenJournal PUBLISHERS Opinion Legalities in All Wound Care Negligence of Care * Lydia A. Corum, RN, MSN, CWCN* Wound Care Program Director * *Corresponding author Lydia A. Corum, RN, MSN, CWCN Wound Care Program Director; E-mail: lydia.meyers317@gmail.com Article information rd th st rd Received: November 23 , 2020; Revised: January 16 , 2021; Accepted: January 21 , 2021 ; Published: February 3 , 2021 Cite this article Corum LA. Legalities in all wound care negligence of care. Emerg Med Open J. 2021; 7(1): 7-8. doi: 10.17140/EMOJ-7-159 ound care costs in the United States exceeds 10 times more the family/patient did not understand why the substitution. This than that of other countries.1 Legal suites are increasingly nurse did right and needs to document exactly what was done at W 2 paid out by clinicians, not the hospitals or the healthcare system. the time of the visit. A better order would be to use generic names Many clinicians are facing lawsuits for malpractice or professional and allow superstitions.4 Writing dressing orders, needs to have neglect. When taken to court and found guilty, the judgment will all information, and treatment products be in generic, if possible. result in a large settlement then include the loss of the clinician’s The orders need to specify: location of wound, type of wound, license.1 Since malpractice has a limited judgement, many lawyers type of primary dressing, if packed location of packing, if tunnel are seeking damages as a result of elder abuse. In using elder abuse, present, what to pack in tunnel, how to address undermining, the the judgements do not have a limitation and often result in very secondary dressing, how often to change, and what to do if there is large settlements.2 Clinicians need to learn how to protect him/ changes in the wound, dressing soiled or not available.5 This allows herself from lawsuits and present the best defense. Areas of negli- the person doing the dressing change to know exactly what to do gences in care are: 1) Failure to follow the provider’s orders. 2) Fail- without questions. With each dressing change the wound needs to ure to properly monitor and observe the patient and the progress be monitored and observed for changes and need to change the of the wound, 3) Failure to report changes in the patient’s condi- dressing.6 tion. 4) Failure to properly document wound assessment properly and with true description.2 The following paragraphs will explain Failure to properly monitor and observe the patient and these failures in greater detail.
wound during the shift is a serious infraction of patient safety.7 When reading the order for the dressing change, if dated and not Failure to follow a doctor’s order can result in due for change, then note in chart: dressing due to be changed disciplinary action by the employer and board of nursing.3 There on X date, current dressing in place, surrounding area without are exceptions, when related to patient safety or against hospital signs of infection, patient does not express any signs of pain or policy. The difference between medication orders and wound care, discomfort.6 Talked with the patient and family about the wound is the fact the patient is seldom at a safety risk or not following progress and when dressing due for changing. No questions at this hospital policy.3 The failure of not following a wound care order, time. With each dressing change there must be documentation could result in the wound not healing properly. An example of a to include: amount of drainage, signs of infection, odor, amount discharge order: “After cleansing the sacral wound, with wound cleanser, of slough or eschar located in the wound, and that the dressing pack lightly with Aquacel, cover with Mepilex Sacral, change every 2-days was changed as ordered, if not why and that physician is called or as needed if greater than 50% drainage or an episode of incontinence.” to report any changes or problems.6 Measuring and picturing the Once the discharging agency receives the order, a nurse is sent wound needs to be made weekly, changes in the wound, on admit, out to evaluate the wound and do the dressing change. What is and on discharge.8 If the wound is deteriorating or worsening, then discovered, is the orders are very specific in the dressing types family, patient, doctor and wound care specialist need to be called 4 7 and none are what the discharging agency has in stock.4 The nurse and informed.7 Then documentation becomes very important to substitutes the products and leaves a message for the doctor. Talks acknowledge increased interventions in place and give explanations with the family and explains what has done and that this will not of what is happening to cause the deterioration. Deterioration of a affect the healing. The nurse substituting products is disregarding wound could be related to wrong diagnosis, poor nutrition, change orders and could be found negligent if the wound worsened and in patient physical or mental condition, or possible infection.2 cc Copyright 2021 by Corum LA. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which Emerg Med Open J. 2021; 7(1): 7-8. doi: 10.17140/EMOJ-7-159 These factors are all important in wound healing. Often with family have respect for you and what you do.2 diabetic wounds, the infection can come on quickly and with systemic signs by the patient. The failure of documenting these