Consider photography to document wound care
August 1, 1996 2 minutes read
Consider photography to document wound care
When Trinity Valley Medical Center in Palestine, TX, opened a wound care center last year, the hospital administration wanted to document the progress made by their wound care specialists.
The risk manager also wanted to limit any possible claims against the hospital for causing and/or exacerbating wounds, says Phillip Morton, RN, the hospital's risk manager/infection control manager.
The hospital treats residents of a nearby nursing facility who often arrived at Trinity Valley with pre-existing bedsores. Morton wanted to make sure that these skin ulcers were documented on the patient's arrival so that the hospital would not be blamed (and possibly sued) for causing the bedsores.
Photography always has been the best way to accomplish these goals, but it can be difficult to actually use because each picture must consistently be taken from the same distance and at the same angle. Typically evidenciary standards require consistency in the distance and angles from which such photos are taken.
To eliminate that difficulty, Trinity Valley purchased a new Polaroid photography system designed for this purpose. The system ensures consistency in distance and angle through the use of converging light beams. When held 10 inches from the wound, the light beams on the camera converge. Special grid film is available for the camera, which when developed, displays a 1 cm-square grid in the background of the photograph.
When used in tandem, the system allows a health care provider to document the progress of the wound, which is otherwise extraordinarily difficult to do in words and drawings in a patient's chart.
"Photographic documentation is becoming more and more popular throughout the health care industry because it can accurately and legally document a condition," says Carol Bamford, MA, vice president of marketing for Briggs Corp., a health care products distributor in Des Moines, IA. "Photography also helps with reimbursement because it can show medical necessity."
Trinity Hospital uses the Polaroid system to document all of the wounds it treats and any pre-existing wounds on a patient, Morton says.
The photographs are kept in a patient's chart. So far, no claims have been brought to test the efficacy of the photographs, Morton says. The system also has been used to document range of motion, Bamford says.
Separate photographic consents
It is unclear whether a hospital must obtain a consent form to use photographs for its own legal protection. If the patient's face is included in the photograph, it is advisable to use a separate consent for photography, Morton says, based on his hospital's legal advice.
Trinity Valley obtains a consent for all photography, however, regardless of whether a patient's face will be visible in the picture. "We are concerned about patient rights. So we offer them a separate consent." If the patient refuses, photographs are not taken.
Bamford also agrees that hospitals should err on the side of caution and obtain a separate consent form for photographic documentation. (See sample consent form, inserted in this issue.) *
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