Coping with the Pressure of Wound Care

Published: May 27, 2006
115

The American Medical Directors Association crafts guidelines specifically for long-term care

Pressure ulcers are serious problems not only for nursing home residents, but for the long-term care industry, as well. In today’s litigious climate, nursing homes must take steps to ensure that their wound management programs quickly identify, treat and, preferably, prevent pressure ulcers. To help them devise programs that are best for both residents and the industry, the American Medical Directors Association (AMDA) offers the Pressure Ulcer Therapy Companion.

Dr. Steven Levenson, chair of the AMDA Clinical Practice Guidelines Project that drafted the Companion, says the AMDA recognized that other groups’ guidelines for the management of pressure ulcers did not focus on the unique needs of the long-term care population or provide a systematic process for pressure ulcer management. As Dr. Levenson explains, “many government-issued guidelines just say, ‘Use a dressing’ or ‘Turn and position the patient,’ but they don’t get into the responsibilities for each staff person. So as a result of these kinds of guidelines, too much is left to the facility to try to figure out how to use them–how to turn a scientific recommendation into a procedure that they can implement effectively.”

In contrast, Dr. Levenson says the Companion presents long-term care facilities with a process-oriented approach that “recognizes the various players or participants, such as nurses, nursing aides and physicians, and tries to define their roles and functions in relation to the wound management process.”

Dr. Levenson points out that the Companion does not outline the specific details on how to change a dressing, for example, but rather provides a framework or foundation on which facilities can build effective wound management programs: “I compare the Companion’s guidelines to the framework of a bridge and the procedures to a roadway. It’s not enough just to have the framework, but you can’t have the roadway without an adequate framework to support it. The policies and procedures of the facility must reflect the steps of the guidelines.”

Displayed is the table from the Companion focusing on facilities’ medico-legal responsibilities in pressure ulcer management.

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