Get the real-time scoop on doctor visits for wound patients. How does your facility follow-up on what transpired at wound-care patients' physician office visits or determine the etiology of leg ulcers? One nursing facility organization has strategies to tackle both of those issues. "We send our treatment nurse with wound patients to their doctor visits so they know what the doctor is thinking and recommending," says Wilma Bailey, BSN, RN, CWCN, ET, CWS, a wound consultant employed by U.S Healthcare Services in Culman, Ala. "We find that's important to do because a lot of times, the physicians don't send paperwork about the visit to the facility." Also: In evaluating leg ulcers, the facilities obtain a Doppler study and ABI (ankle brachial index) to assess a resident's arterial blood flow. "The majority of the time, if you check the patient's lower extremity pulses and observe the skin" you can tell whether a wound may be vascular in nature, says Bailey. For example, if a wound is arterial, the skin may be hairless and shiny, she observes. "But we take that extra step. Surveyors are impressed with that." Another safety tip: "When patients have amputations ordered, we have the physician order a Doppler study to show where the blood flow ends," adds Bailey.