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wound photography, evidence-based standards for wound photography, competency in wound photography



  1. Bradshaw, Leah Marie MSN, RN, CWS
  2. Gergar, Margaret E. MSN, RN, CWON
  3. Holko, Ginger A. MBA, BSN, RN, CWS


PURPOSE: To enhance the learner's competence in using digital imaging of wounds for the medical record.


TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.


OBJECTIVES: After participating in this educational activity, the participant should be better able to:


1. Apply a standard data collection and documentation method for wound photography (WP).


2. Design a training and competency program for WP.


3. Use clinical practice guidelines and performance checklists to ensure an effective WP program.





OBJECTIVE: The objective of this study was to enhance conventional wound assessment and documentation of clinicians by incorporating the use of digital imaging into the medical record using standardized photography requirements.


DESIGN: A review of current literature, existing clinician practice, and identification of barriers preceded the development and implementation of a clinical practice guideline, with a performance checklist, aimed at improving the wound photography (WP) process. In addition, establishing standards of practice and behavior modification were used to improve clinician proficiency in digital photography.


SETTING AND PARTICIPANTS: Wound clinicians providing specialty care within the acute care setting.


MAIN OUTCOME MEASUREMENTS: Following educational sessions, evaluation of clinician competence in using equipment and adherence to standard digital imaging protocols with the use of a performance checklist permitted educators to validate clinician skill.


MAIN RESULTS: Establishing consistency in digital imaging results is an overall enhancement of the WP process by increasing clinician satisfaction and efficiency, improving assessment skills, and enriching documentation. Competency strengthens one's skill set and serves to create a common language, leading to improved communication among clinicians and resulting in enhanced wound assessment.


CONCLUSIONS: WP plays a valuable role in delivering effective patient care by strengthening wound assessments and documentation. Recognizing the need for consistent standards, clinical educators from Lehigh Valley Health Network designed an educational program using a multifaceted approach, including clinical practice guideline development, education, and competency assessment. Enmeshing current practices, expert opinion, and clinician knowledge resulted in an innovative process using interdependent, yet independent, components to achieve enhanced wound assessment.