For Immediate Release

International Wound Care Experts and Medline Issue White Paper on Legal Issues in the Care of Pressure Ulcer Patients

Thought leaders provide insight on eight key areas of vulnerability


Thursday, June 25, 2009 —

The International Expert Wound Care Advisory Panel today released a 23-page white paper titled "Legal Issues in the Care of Pressure Ulcer Patients: Key Concepts for Healthcare Providers," detailing and identifying key concepts to help healthcare professionals with preventative legal care practices taking into consideration the current pressure ulcer regulatory and legal environment.  These key concepts are based on a recent roundtable discussion of eight thought leaders on the various legal implications of these policies and ways in which healthcare workers can reduce their risks.  The roundtable and paper were supported by an educational grant from Medline Industries, Inc.

Every year, pressure ulcers affect more than one million acute care and nursing facility patients.  Lawsuits over pressure ulcers are becoming increasingly common in both settings, with claims per occupied bed increasing at an annual rate of 14 percent and the average court settlement rising more than $250,000. In addition to the bottom line implications – Medicare data estimates the average cost associated with pressure ulcer treatment is over $40,000 – a pressure ulcer-related lawsuit can do severe damage to a facility's reputation for providing quality patient care, devastating staff morale and turning clients away.

 "The interrelationship between medical decision-making, reimbursement and legal issues relating to pressure ulcers has never been greater and the medical-legal landscape itself has never been more treacherous," said the paper's corresponding author Caroline Fife, M.D., C.W.S., Associate Professor of Medicine, Division of Cardiology at the University of Texas Health Science Center. "This white paper is a valuable resource for clinicians, managers, administrators, risk managers and industry members to establish or reinforce not only the aspects of a good pressure ulcer prevention process, but also how that goal can be achieved without an increase in litigation."

Topics covered in the white paper include eight key areas of vulnerability for institutions:

  • Assessing the Legal Implications of Healthcare Facility "Policies and Procedures"
  • Assessing Compliance with Prescribing Rules
  • Changing and Practicing within Scope of Practice
  • Managing Expectations and Communicating Carefully
  • Clinical Documentation
  • Preventability: Avoidable, Unavoidable, Preventable or Never Events?
  • Education: The Need for Learning Never Ends
  • Preventive Clinical Care

Pressure ulcers, also known as bedsores, pressure sores or decubitus ulcers, occur in hospitals, nursing homes and long-term care facilities as a result of multiple internal and external factors, including unrelieved pressure on the skin. The lack of blood flow to an area of the skin may first be noticed as a change in color such as red in light skin or darker brown or black in darkly pigmented persons or irritated skin.  Areas of deep tissue death may not be readily visible until they result in large open wounds.
 
When the treatment and prevention of pressure ulcers comes under legal scrutiny, it is often alleged as negligence. According to the authors, the readily apparent nature of pressure ulcers means that, unlike many other medical complications, they never go unnoticed by patients and their families.

Co-author Dr. Diane Krasner opines, "It is critical that everyone who is involved with pressure ulcer litigation – patients, families, caregivers, attorneys and healthcare team members – recognize that the vast majority of pressure ulcers are not due to negligence or non-compliance on anyone's part, but rather they are unavoidable due to a patient's risk factors, illnesses, co-morbidities and other complicating factors."

The International Expert Wound Care Advisory Panel that developed the white paper is comprised of eight industry thought leaders:

Elizabeth A. Ayello, Ph.D., R.N., A.C.N.S.-B.C., E.T.N., F.A.P.W.C.A., F.A.A.N.
Excelsior College, Albany, N.Y.

Kathleen Leask Capitulo, D.N.S.C., R.N., F.A.A.N.
Transcultural Nursing Leadership Institute, New York, N.Y.

Caroline E. Fife, M.D. C.W.S.
University of Texas Health Science Center, Houston, Texas

Evonne Fowler, M.S.N., R.N., C.W.O.N.
San Gorgonio Memorial Hospital, Banning, Calif.

Diane L. Krasner, Ph.D., R.N., C.W.C.N., C.W.S., B.C.L.N.C., F.A.A.N.
Rest Haven-York, York, Pa.;

Gerit Mulder, D.P.M., M.S.
Wound Treatment and Research Center, Department of Surgery/Division of Trauma,
University of California San Diego School of Medicine, San Diego, Calif.
 
R. Gary Sibbald, M.D. MEd, F.R.C.P.C., M.A.C.P., F.A.A.D., F.A.P.W.C.A.
Wound Healing Clinic, Women's College Hospital, University of Toronto, Canada

Kevin W. Yankowsky, J.D.
Fulbright & Jaworsky, LLP, Houston, Texas

Members of the panel will also be presenting information from the paper at the Symposium on Advanced Wound Care in Washington, D.C. on September 16th during a session titled "Wounds & Litigation: How to Safeguard Your Practice & Your Facility."

For more information and to receive a copy of the white paper, visit Medline's Web site at www.medline.com.

About Medline

Medline, the nation's largest privately held manufacturer and distributor of healthcare products, manufactures and distributes more than 100,000 products to hospitals, extended care facilities, surgery centers, home care dealers and agencies and other markets.  Headquartered in Mundelein, IL, Medline has more than 800 dedicated sales representatives nationwide to support its broad product line and cost management services.
 
Over the past five years, Medline has been the fastest growing distributor of medical and surgical supplies in the U.S., serving as the primary distributor to over 250 major hospitals and health care systems. As a leading distributor, Medline offers a comprehensive array of consulting and management services encompassing the supply chain and logistics, utilization and standardization, business tools and enhanced reporting capabilities, and on-staff clinicians.

Medline has a growing network of 34 distribution centers around the country, as well as an expanding, dedicated transportation fleet with over 160 vehicles in a variety of sizes to fit customers' specific delivery needs. The fleet is equipped with the latest navigation devices for enhanced order tracking and communication.