Heidi Huddleston Cross – Legal and Regulatory Issues in Wound Care: Avoid Wound Issues and Keep Yourself Out of Court

Outline

Introduction

• Basics of the U.S. legal system
• Why do people sue?
• Chronic wounds (especially pressure ulcers) – why are they such a hot topic?
• Negligence
• Definition of adverse events
• Standards of Care – where do we find them?
• The economic, professional, and personal impacts of litigation

Regulatory Issues and How They Affect Your Wound Care Practice

• Federal statutes and regulations
• Hospital Acquired Conditions and Never Events – can we really always avoid them?
• Those dreaded Department of Health and Joint Commission surveys
• Code of Federal Regulations – Requirements for Long-Term Care Facilities
• State Practice Acts and practicing within your scope

Assessment Essentials

• Risk assessment
• Patient assessment
• Wound assessment
• Nutrition assessment
• Mobility assessment

Legally Defensible Documentation

• What MUST be in the record to effectively defend yourself and your institution
• The 5 Cs of effective documentation
• Pitfalls to avoid
• Electronic Health Records: a boon or a bust when it comes to wound documentation?

Communication Essentials

• With the patient
• With the family
• With the physician
• Multidisciplinary involvement and communication

Sticky Situations in Wound Care: Helpful Hints to Minimize Your Legal Risk

• Pain management – Avoiding a “Pain and suffering” allegation
• Nutritional allegations – Delay or failure to provide appropriate nutritional interventions
• Policies and procedures – can make or break your defense
• Staffing levels and competency
• Wound photography – pro’s and con’s and guidelines
• Malpractice insurance – is it necessary for nurses?

Issues with Select Types of Wounds

• Pressure ulcers – avoidable versus unavoidable
• Arterial ulcers
• Diabetic ulcers
• Know the etiology: dangers in failing to correctly diagnose and treat

You Make The Call

• Case studies and scenarios