Publish date: 25 March 2024
Correct utilisation in wound care management in relation to process, quality, frequency and the safe upload and storage of images on electronic patient records.
All healthcare professionals using digital photography in wound management within Community Care Services Division must ensure safe and correct practices are followed. Guidance can be found in Clinical Digital Photography and Videography Policy No 30 as well as a helpful summary in the attached 7 minute briefing, which covers the whole process including capacity and consent. All clinical staff are responsible for:
- Assessing when a clinical photograph is required
- Obtaining and recording appropriate consent from the patient
- Uploading relevant clinical photographs to the patients’ electronic record with associated progress note
- Ensuring that all reasonable steps are taken to ensure the confidentiality and security of the photographs. Where there is a need to send a photograph to another healthcare professional, the Trust guidelines in the secure sending of images must be adhered to.
A Trust issued digital device (smart phone or tablet) must always be used for the taking, storing and uploading images (healthcare professionals should not use their own device) and digital photography should be of good quality.
In terms of quality – all images must be of sufficient quality to assess the clinical condition being reviewed. The healthcare professional needs to consider:
- Image quality of the device being used
- Focus: to ensure a clear sharp image ensure that the item being photographed is within the focus range of device
- Device stability: particularly in low light conditions care must be taken to ensure the image is not blurred because of device shake
- Lighting and Background - It is important to consider the lighting available to ensure sufficient detail of the wound can be recorded in the final image. The background should be plain and neutral
- Position of the patient - It may be easier to photograph the patient lying down because some wounds (particularly those on the buttocks) distort easily.
In terms of frequency - digital photography is an important tool in the assessment and evaluation of wounds. It is the healthcare professional’s responsibility to decide when it is appropriate to undertake clinical photography, however in relation to wound assessments the frequency should include at the minimum, once a new wound has been identified initially, and subsequent wound assessments, as part of wound care management. This will also include any deterioration. This allows health practitioners to compare and monitor any progress or deterioration. Also helps if staff are unsure re categorisation or aetiology as this can be brought back and discussed with wider team directly involved in patient’s care.
Other important considerations
It has been highlighted through learning derived from some rapid reviews, that many photographs of wounds uploaded onto EMIS, do not have any patient identifiers or are of poor quality. It has also been articulated that some staff are uploading images from the healthcare professional’s own email account (this is a serious breech in terms of Information Governance) and is also not in adherence with the Policy. Any breaches in IG must be Radared. It is essential that the security of all images is maintained and that any electronic exchange of information is in line with Caldicott principles. As stated above, Images must be uploaded from a trust’s digital device onto the Electronic Patient Record (as described in policy above) and attached to the patient’s individual record as soon as possible after the image is taken. Once images are uploaded and attached to the patient’s individual record, they should be permanently deleted from the smartphone.
For more information, please contact michelle