We have a disagreement regarding the taking of photos at our facility. We take pictures of open wounds only. Do other facilities take pictures of other conditions, like bruises?

There is an open can of worms concerning photos, with some corporations wanting photos on everything, and some forbidding photos. 

The most important thing, in my opinion, is to be sure you follow the policies of your facility or corporation. Do not go against these policies, and if you have questions or concerns, please be sure to check with your boss (whether it’s a director of nursing, administrator, executive director, etc.).

Many corporations take pictures of bruises if they are significant and appear on the face, neck or breast; if the bruises are large, have particular shapes or fingerprints; or when no one knows how they occurred. Any bruise that looks unusual or suspicious or needs to be investigated to rule out abuse should be photographed.

There also are programs that many facilities use that require assessments, with or without photos. 

You need to be consistent. If the day shift is taking pictures of all wounds and bruises and that is the policy, then all three shifts need to be doing the same thing. The easiest way to send inspectors on a hunt is to be inconsistent with your policy. 

Some quick audits will help you check for pictures and notes to be sure everyone is documenting the same way. Also, be sure that any wounds or bruises are discussed at your stand-up meetings. Don’t let these cases fall between the cracks, as I can assure you the first day you don’t discuss one of them, there will be a significant change in condition with no follow-up note or proper documentation.

I repeat: Be consistent and follow your formal policies.