Interdisciplinary Wound Care Team

When improvement’s not occurring and there’s a known reason for it, you got to make sure you document that. Your documentation should, at the minimum, include a measurement of the length, the width, the depth, the tissue type, the exudate, odor and the periwound description. Three of those things are important to have, actually the length, width and depth, included as being one as a measurement, and the tissue type. Actually, those are important to document, because we use those in a calculation of a push score.

But sometimes, what we do include in those measurements is determined by that local coverage determination that we talked about. They say that for the assessment of wounds, for the payment of wound care services, almost all of them say that you have to have at least documentation of the drainage, any inflammation, swelling, pain, the dimensions and the presence and or absence of necrosis and or slough.

One of the standards is to measure based on the anatomical position of head to toe, with the head being 12:00, and the toes being 6:00. We’ve drawn a very obvious line here in this slide, so we know where 12 to six is. You can see the anatomical position, the way they’re holding their hands, so that you know what is 12 and what is six.

These are some pictures of wounds that show various positions of patients. I’ve drawn a black arrow showing you the 12:00 to 6:00 position on each of these wounds. We would do that as the length. The width would be perpendicular to that particular line at the wound’s widest point.