As for all clinical recording, it is important to ensure that equipment and procedures are standardised as much as possible. This is achieved by careful control of equipment, material, lighting, viewpoint, background, technique and post production.
Firstly, the quality of the photograph is important so that tissue types can be identified and the progression of a wound can be tracked over time. This is dependent on a number of factors such as the skill of the photographer, the lighting and of course the camera. In a hospital setting these limitations can be controlled to some extent by using a medical photographer and ensuring that the same camera is used when each photograph is taken. It is more difficult to control the lighting and to ensure that the photograph is taken from the same angle on each occasion when there are different people taking the picture.
Other limitations of using photography include the difficulty to demonstrate wound depth and to accurately record wounds on curved surfaces (Dealey, 2005). It is helpful to view any previous images in an effort to achieve repeat views. The most difficult variable to control is the patient’s position. When photographing wounds over heels and elbows care should be taken to ensure that the patient is being photographed from the same side as previous images (Institute of medical illustrators, 2007; 2019).
Most hospitals are now are engaging the services of Medical Photography, however many nurses caring for patients with wounds do not have access to a medical photographer and have attempted to capture wound images as an unambiguous record of wound status.
How photographs are obtained is important. (Hampton 2016) If there is a camera that is owned by a Trust, it should be stored securely and any photographs taken downloaded to a computer as soon as possible and deleted from the camera. (Hampton 2016)
There are some occasions where patients might take their own photographs of their wound and healthcare professionals may feel it would be beneficial to the patient management plan to have these photographs stored within the patient’s medical records. In order to do so, it is important that there is a system in place whereby the images can be securely received and uploaded to the patient’s record (any upload of such material to the patient record must be done in accordance with local trust policy). (Institute of medical illustrators, 2019).
At this point it is important to consider the implications of patient consent and confidentiality.
Many trusts have their own medical photography policy and prior to photographing a patient, the individual practitioner must ensure they are complying with local and national policies regarding medical photography.