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Wound Care Management in Residential Aged Care becomes a Coroners Case

This edition of the Residential Aged Care Communiqué focuses on the case of a resident with multiple wounds. Many people were involved in the provision of care over many months, and yet the actions needed to provide definitive care did not happen. The case highlights multiple aspects of clinical care – wound care management, teamwork, communication, deference to experts and demonstrates the complexities of delivering this in a residential aged care setting. These are challenges we face every day and many aspects are addressed in the new Aged Care Quality Commission’s National Standards.

Ms KS was a 96-year-old female resident in a privately owned residential aged care service (RACS).

  • She was bedbound – requiring mobility aids for transfer
  • History of:
    • Insulin-dependent diabetes
    • Hypertension
    • Dementia
    • Hypothyroidism
    • A skin condition called bullous phemphigoid
    • Sustaining multiple skin tears

Five months before her death she had two wounds that caused concern…
The problem was that there appeared to be no co-ordinated and well-communicated strategy to manage the wounds.
The documentation available was inadequate to meet the care needs of the client, and the communication with both the family and specialist health care workers was fragmented.

Part of the Coroner’s findings were:

The coroner found that the care provided in relation to wound care, was not adequate with respect to documentation, treatment provided and referral for medical intervention and escalation of care. The wound care management plans were also not strictly in accordance with the RACS Wound Care Policy in place at the time. No photographs or measurements were taken of the left and right leg wounds for six and three weeks prior to hospital admission respectively. The RACS staff had not escalated care as they accepted the GP view that the wounds were improving and because the wound consultant was involved in the care.

To read the full account go to the Residential Aged Care Communiqué website click here>>