As a healthcare professional, it is no longer enough to simply follow orders. All professionals who care for patients with wounds are now being held to a standard of care, and may be held liable for providing wound care of substandard quality, regardless of whatever they believe they are covered by a physician's order. Therefore, wound care practitioners need to be aware of these standards in order to protect their patients and avoid legal issues and denial of reimbursements.
Legal issues involving wounding care management are generally an issue of negligence, or failure to meet the standard of care. Malpractice can be defined as failure to meet standards of care that results in harm to another person. Healthcare professionals may be held liable in the event it is determined that standards of care have not been met, and may be guilty of malpractice if a patient under their care is harmed.
What is the standard of care in wound care management? Standards of care can be defined as the care that any reasonably prudent health care provider would provide in the same or a similar situation. Standards for wound care practice have been determined by several sources:
- Agency for Healthcare Research and Quality – the Agency for Healthcare Research and Quality (AHRQ) has set out guidelines for the prevention and treatment of pressure ulcers.
- Patient Care Partnership -the patient care partnership includes basic patient rights, one of which is safe, quality care
- State nurse practice acts and guidelines -these acts regulate the practice of nurses, and define which treatments and actions may be performed by the nurse in each state
- Employer policies and procedures -policies and procedures are used to establish standards of care, and may be invoked in litigation claims-such claims may reflect either lack of knowledge or blatant disregard for a policy, and may show negligence
- Job descriptions -health care employees who provide care outside their formal job description may be heldiable
- Standards of practice -various professions have individual standards of practice, set by the professional organizations
Medicare has determined that, as of October 2008, they will no longer recover for mainly preventable conditions, including pressure ulcers. This ruling means that healthcare professionals must focus not only on preventing pressure ulcers, but also in treating them when they occur using evidence based wound management procedures. This is but one example of how all healthcare professionals are being held to certain standards in wound care management. It is likely that this trend will continue and that, increasingly, professionals who care for patients with wounds will be held responsible for meeting these standards.
Obtaining wound care certification not only guarantees knowledge of the current standards in wound care, but also ensures that the certified wound care practitioner places current with best practice standards, as maintenance of wound certification requires proof of annually continuing education as well as periodic retesting.