QMAs Documented Wound Care Outside Scope of Practice
Penalty
Summary
Qualified Medication Aides (QMAs) at the facility signed off on wound care treatments for multiple residents with pressure ulcers that were outside their scope of practice. Specifically, QMAs documented completion of treatments for residents with stage 3, stage 4, and unstageable pressure ulcers, which, according to facility policy and state guidelines, should only be performed and documented by licensed nursing staff. The clinical records for four residents showed that QMAs signed for wound care treatments on several occasions, despite these wounds being more severe than a stage one, which is the limit of their authorized practice. Interviews with staff confirmed that QMAs are not permitted to perform or document treatments for wounds above stage one, and that nurses are responsible for these tasks. However, QMAs reported that they sometimes signed off on treatments if a nurse forgot to do so. The facility's policy and state regulations were provided, clearly stating the limitations of the QMA role, including restrictions on documenting treatments performed by others and on treating wounds more severe than stage one.