As a legal nurse consultant, I have been involved in a case analysis that raises an important question regarding the role of nurses in skin care and wound management. The question posed to a nurse expert during deposition highlights a significant gap in practice and policy, bringing to light the need for better collaboration between bedside nurses and specialized wound care teams. In this blog, we will explore the unique position of nurses in maintaining skin health, the evidence gap in support of best practices, and the importance of early involvement of WOC Nurses and Wound Teams in patient care.
The Fundamental Care Aspect:
Jan Kotter, immediate Past President of the European Pressure Ulcer Advisory Panel (EPUAP), emphasizes that nurses have a professional responsibility to lead skin care maintenance while citing an evidence gap in literature supporting interventional practice (Kotter, 2023). This paradox highlights the failure to recognize the significance of this fundamental aspect of care, which is often overlooked until it becomes a pressing issue. The delivery of evidence-based care does not guarantee quality outcomes, especially when addressing complex pressure injuries. It is crucial for nurses and wound care teams to work together to provide comprehensive care, considering both intact healthy skin and at-risk patients.
Skin Care vs. Wound Care:
It’s essential to distinguish between skin care and wound care as separate entities, rather than bundled skills. While wound care receives significant attention due to its urgent nature, the importance of skin care should not be underestimated. Skin care practices are often overlooked until an injury occurs, yet it’s a vital aspect of patient safety. The Braden Scale and risk profile assessments can help identify high-risk patients, triggering early interventions and collaboration with WOC Nurses and Wound Teams. In medical malpractice cases involving pressure injuries, thorough documentation of skin integrity is critical throughout the medical record.
The Indispensable Role of the WOC Nurse and Wound Care Teams:
Wound Care Teams play a crucial role in providing specialized care for patients with wounds. Their leadership and expertise are essential to ensure comprehensive management of complex wounds. However, the involvement of bedside nurses in skin care practices cannot be overlooked. The initiation of skin consultation depends on facility policies and procedures, but the participation of WOC Nurses is non-negotiable for an interprofessional approach. Inpatient settings pose unique challenges due to patients’ increased risk of soft tissue damage, making it imperative that bedside nurses prioritize skin care alongside wound care teams.
The importance of skin care in patient safety cannot be stressed enough. It’s time we recognize its value and place equal emphasis on healthy skin maintenance as we do with other vital organ systems. Recognition of skin care by the bedside nurse is urgent and vital, and integral to the everydayness of nursing care. As nurses, we must take a proactive role in advocating for early involvement of WOC Nurses and Wound Teams in high-risk cases. By bridging the gap between skin care and wound care practices, we can ensure better outcomes and mitigate potential risks associated with pressure injuries. I invite your comments and thoughts on this critical issue. Together, let’s raise awareness about the significance of skin care in patient safety.
Kottner, J., 2023. Nurses as skin care experts: Do we have the evidence to support practice? Int. J. Nurs. Stud. 145, 104534. https://doi.org/10.1016/j.ijnurstu.2023.104534