Wound Care Provided Outside Scope of Practice by MA-C
Penalty
Summary
Nursing staff failed to ensure that wound care was provided within the appropriate scope of practice for two residents. Observations showed that a Medication Assistant-Certified (MA-C) performed wound care procedures, including the application of Vashe solution and xeroform, on open wounds. The MA-C did not perform wound measurements or assessments, stating that these tasks were reserved for nurses and were only completed by the wound team on specific days. Documentation revealed that wound care treatments for one resident were performed by a MA-C, and on some scheduled dates, treatments were not performed at all. Interviews with facility staff indicated uncertainty regarding the MA-C's authority to apply topical medications to wounds. The infection preventionist/staff development coordinator was unable to provide competencies for MA-Cs performing wound care and acknowledged that MA-Cs should not apply topical medications to wounds. Review of state nursing board advisory opinions confirmed that CNA IIs and MA-Cs are not permitted to apply medications, including topical agents, to wounds, and that wound care by CNA IIs is only allowed after assessment by a provider or RN. No evidence was provided to show that the MA-C's actions were within their legal scope of practice.