Professional Practice, Safety, and Role Responsibilities
Know your scope and your standards
Practice is bounded by the state nurse practice act, facility policy, and professional standards (WOCN Society, NPIAP, AHRQ, and current evidence-based guidelines). Wound assessment, identification of etiology, and care planning are nursing responsibilities that cannot be delegated to unlicensed assistive personnel; tasks such as bathing or applying a prescribed dressing may be delegated with teaching and supervision. Escalate beyond your scope - a suspected arterial ulcer, exposed bone, or a deteriorating patient - through the chain of command.
Safety and infection control
Standard precautions and hand hygiene apply to every wound encounter. Use sharps safety devices, never recap needles, and dispose of blades in sharps containers. Follow safe patient handling for repositioning and transfers. Practice antimicrobial stewardship: culture only when clinically indicated, avoid routine prophylactic antibiotics, and limit topical antiseptics to defined courses. Protect health information per HIPAA and photograph wounds only with consent and per policy.
Documentation that protects the patient
Chart objective, reproducible findings: measurements, tissue percentages, exudate, periwound status, pain, interventions, and response. Documentation supports reimbursement, quality reporting, and is the legal record. Hospital-acquired stage 3, stage 4, and unstageable pressure injuries are treated as "never events" and trigger root-cause analysis.
Ethics, advocacy, and the team
Informed consent, truth-telling about prognosis, and respecting refusal of care are core obligations. Collaborate with dietitians, PT/OT, podiatry, vascular surgery, and infection prevention, and participate in quality improvement and evidence-based practice while maintaining certification through continuing education.
Trap and rule of thumb
Questions showing an RN delegating initial wound assessment, or a nurse acting outside policy, typically have one correct action: stop, clarify scope, escalate. Rule of thumb: if you would not be comfortable defending it in a chart review, do not do it.