PRESSURE ULCER TREATMENT ORDERS

POLICY:
RN or designated skin care provider may determine the need for and implement appropriate skin care treatment based on assessment and wound care protocols.  The physician will be notified of any pressure ulcers and advised of selected treatment.  Any deviations from treatment protocols recommended by physician must be approved by Medical Director.

The following treatment requires a physician order:

  1. lab work
  2. multi-vitamin/mineral supplement
  3. debridement - sharp, surgical, enzymatic, whirlpool
  4. use of topical antibiotics
  5. any treatment involving leg ulcers which may be venous, arterial or diabetic

PROCEDURE:
When writing treatment orders to alert the physician the following must be included in the order.  (On yellow physicians order sheet and right side monthly order sheet).

  1. The site of the wound - each site should have a separate order.
  2. What to cleanse wound with.
  3. What to apply to the wounds as the primary dressing.
  4. What to apply to the wounds as the secondary dressing (if applicable).
  5. How often the treatment should be done.  (Be sure to include PRN changes).
  6. Do not write to do treatment until healed.  Treatment order should have specific order to DC when ulcer is healed or when changing treatment.

The following are examples of how treatment order should be written:

  1. Apply 4X4" duoderm with border to stage 1ulcer on coccyx; change every 3 days and prn per wound care protocol/N.  Nurse, RN.  (Doctor will co-sign order.)
  2. Irrigate stage 3 ulcer on 1t hip with saf-clens.  Apply Kaltostat rope, cover with Combiderm 6X6"; change daily and prn per wound care protocol/N. Nurse, RN. (Doctor will co-sign order.)

Orders shall be transcribed onto MAR sheet and wound assessment sheet.

Formulated: 7/98

Revised:

Reviewed:

ACWCP - 1998