Q: What should you assess when a patient is being discharged from a post-acute long-term care setting with a wound?
A: It is important to know what outcome to expect when a patient with a wound is being discharged from a rehabilitation facility. Will the wound heal or maintain its status quo or is it non-healing? As many efforts are made to heal any wound, one needs to know the key factors that will guide care.
The first priority is to assess the healing ability of the wound. Factors that foster wound healing include a correctable cause and adequate blood supply. Non-healing wounds, on the other hand, do not have a correctable cause or adequate blood supply.
Wounds often persist though they may have the capability to heal. Both patient-related factors and healthcare factors can impair healing. Administrators, nurses and others should understand whether a patient can help care for himself or herself and how the patient perceives the wound.
Also, ask if the patient is able to access and afford necessary wound care products. Does the patient or a caregiver know how to care for wound care equipment? Often, these inquiries are made but missed at discharge, resulting in wound deterioration, infections and recurrent hospitalization. Person-centered care may take extra time but can lead to much better outcomes.
Documentation of these assessments are an important part of resident care. Litigation and liability risks amplify if such care is not documented. The documentation of initial assessment, daily monitoring and weekly assessment is the minimal expectation by the Centers for Medicare & Medicaid Services. Excellent patient care and timely documentation saves the residents and the facilities from unwarranted frustrations and litigation. After all, what is not documented is not done!
Please send your wound care-related questions to Fatima Naqvi at [email protected].
