We currently have a patient that requires daily dressing changes for a sacral wound. The order from the physician for us is "Please send skilled nurse out 2x per week for dressing changes for sacrum wound and skilled wrap change." Just under that is an order to the private duty nurse that states, "Please help patient to apply Farrow wrap to right foot and leg each morning. Please place pneumatic compression sleeves to both legs and turn on. Please assist patient with sacral wound dressing."
Normally, we would provide education to family members that are going to perform the wound care on the days we aren't there, and have supplies in the home for those dressing changes. In this case, there is another entity that we don't control. My concern is if the wound deteriorates. We can't ensure the private nurse is performing good wound care. With the family, we can at least document the steps we've taken to try to ensure good technique.
Also, with an order written like this, do we still provide all needed wound supplies under the patient's Medicare policy, or are we only responsible for the days that are ordered for us?
Thanks
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J Scott Lambert MPT, JD
Director
Washington Regional Home Health
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