Nursing Home Medical Negligence Warning Signs: Bedsores (Pressure Ulcers)
In this section of A Time to Care: A Guide to Nursing Home Care, Greenville nursing home abuse attorney Andy Arnold discusses one of the warning signs of medical negligence and substandard care in long-term care facilities: bedsores, also known as pressure ulcers.
Bedsores / Pressure Ulcers
Bedsores, or pressure ulcers as they are sometimes called, are a serious and unfortunate common occurrence among residents in nursing homes. This is so because the most significant risk factor of developing a bedsore is immobility--someone who cannot move or get out of bed on their own and must depend on the care of another. Because most bedsores are preventable, the mere existence of one may indicate medical negligence and a failure by the nursing home to properly reposition a resident, among other failures.
In short, a pressure ulcer is caused by unrelieved pressure on the skin that results in damage to the underlying skin tissue. There are four stages of bedsores.
Stage I is an observable redness (alteration of skin) caused by pressure.
Stage II is an observable thinning of a skin area and appears as a blister or abrasion.
Stage III is an observable thinning and skin loss with damage to the underlying tissue and appears as a deep crater or blister.
Stage IV is a full skin loss with extensive damage to the skin and underlying tissue, involving necrosis (rotting of skin) and may cause damage to the muscle and bone.
When someone is first admitted to a nursing home, the nursing home should perform a full evaluation of the resident to determine the existence of any risk factors for developing a bedsore. The following are a number of risk factors that should be considered by a nursing home when caring for a resident to prevent a bedsore:
a. Immobility-confined to bed or a chair.
b. Inability to turn or reposition oneself.
c. Poor or inadequate nutrition and hydration.
d. Altered level of consciousness.
e. Medical condition that may cause weakening of the skin.
If a resident has one or more of these risk factors, the nursing home should take proper steps to prevent the development of bedsores. Having these risk factors does excuse the nursing home if a bedsore develops, it only means the nursing home should provide additional care to prevent them.
To prevent the development of bedsores in an at-risk resident, there are many steps that should be taken:
a. Turn and reposition the resident a minimum of every two hours so that the pressure on the skin is relieved.
b. Inspection of the skin at least once daily for evidence of any redness.
c. Reduce the elevation of the head of the bed to reduce friction-the resident sliding down in the bed.
d. Keep the skin dry and clean.
e. Make sure the resident has proper nutrition - adequate calorie and protein intake. This helps the skin get nourishment and stay healthy.
f. Activity. The nursing home should attempt to improve the mobility of the resident.
g. Use of an air mattress or other specialized bed helps reduce pressure to the areas of the skin that receives the most pressure.
These steps are fundamental and should be taken by the nursing home. Existence of a bedsore usually means one or more of the above steps were not followed by the nursing home.
And if after all precaution and necessary steps are taken, a resident develops a bedsore, which is doubtful, the nursing home has a responsibility to take an active and aggressive approach to healing the bedsore.
The most important part of healing a bedsore is early detection. This should be accomplished if the nursing performed the daily skin inspection. If a bedsore is not detected until Stage II or later, this is an indication that the daily skin inspections were likely not taking place.
After detection of a bedsore, a review of the resident's charts should be made to identify what caused the bedsore. At that time, all caregivers (dietician, doctor, nurse, and CNA) should be consulted to develop a care plan to promote healing of the bedsore. The dietician should make sure the resident has proper nutrition and to adopt a diet that promotes the healing of the bedsores and nourish the skin. A re-evaluation should be made of the care plan if the bedsore is not healing.
Bedsores are arguably the most serious problems facing residents in nursing homes today. Unfortunately, because most can be prevented, this means that nursing homes are simply not caring for the residents in most of these bedsore incidents (the section of this nursing home guide on staffing illustrates how the necessary care is not being provided).
Experienced South Carolina Nursing Home Abuse Attorney Can Help
As an experienced nursing home abuse attorney in Greenville, SC, Andy Arnold has handled several cases involving preventable pressure ulcers. Lawsuits for failure to prevent and properly treat pressure ulcers are not uncommon, so attorneys representing nursing homes have learned various tactics to defend these cases. The family of the neglected patient needs a lawyer with the same level of experience and skill if they hope to be successful. If you need help pursuing a lawsuit for medical negligence of your family member in a nursing home, call Andy Arnold's office at 864-242-4800. Schedule a free nursing home abuse consultation today.