OASIS Alert

Show skin breakdown and verify your staff's work in one step.

A picture is worth a thousand words, so just imagine how clear and helpful it could be when you're dealing with wound care -- especially when you're trying to supplement your outcomes and reap full reimbursement for your hard work.

Consider this: Many items (like M1308,M1304, M1342, and M1350) ask specific questions about patients' wounds. Other items (such as M2100 and M2250) want information about your agency's treatment and care plans. Your written documentation does a wonderful job of recording all the details of your patient care, but a photograph does what all the writing in the world can't -- provide visual proof of your efforts.

There are several reasons an HHA would want to incorporate photography. For instance, you might take a photograph at the onset of care to show that pressure ulcers were present, notes the National Pressure Ulcer Advisory Panel (NPUAP). Any photos taken during treatment provide visual documentation of your treatment plan.

Other advantages include:

• You can demonstrate that a patient came to you with an ulcer (versus developing one in your care).

• Your staff should photograph all body surfaces at risk of skin breakdown, helping you better track and prevent wounds.

• You obtain a more accurate means for assessing dimensions and base characteristics over time.

• You end up with a record that verifies your staff's attention to wound problems.

Downside: Using photography won't solve all problems. A photograph can't capture the full extent or severity of deep-tissue injury, NPUAP points out. Photos also may undermine a patient's faith in treatment if an ulcer doesn't change significantly from onset to discharge.

Other disadvantages include:

• Purchasing equipment and training aides to use it correctly presents a whole new set of challenges.

• Photographs of large pressure ulcers

can be inflammatory in a jury trial despite compliance

with all reasonable standards.

If your agency wants to start using photography to document wound treatment, you must create an easy-to-follow and consistent set of protocols, NPUAP stresses. Make sure you address and train on these areas in your final policy and procedures:

• type of photography you'll use (digital, Polaroid, etc);

• photographic standards you expect (aperture settings, distance from wound, field of view, etc);

• how to identify patients in a safe, confidential way;

• how to mark the date and time on each photograph;

• the sample measure you'll use to show the wound's scale;

• whether you'll supplement photography with a software program; and• who you'll share the photos with (doctors, other treating professionals, etc).