Bed Sores and Other Pressure Ulcers
When hospitals, physicians, and nurses are negligent and do not move a patient that cannot move him or herself, pressure ulcers can develop. Often referred to as pressure sores or bed sores, pressure ulcers are painful wounds that create a serious risk for infection. Essentially, when the body is in the same position for too long, the skin on areas of high pressure (the buttocks and heals for example) degrades. In serious cases, the fat, muscle and even bone can degrade as well. Pressure sores are highly litigated and are the second most common cause of civil suits alleging medical malpractice — superseded only by wrongful death suits. Serious pressure sores – those that begin to degrade the flesh – should never happen. Serious pressure ulcers are “never events” according to CMS.
If you or a loved one developed a pressure sore while in the hospital, contact our medical malpractice attorneys today for a free case review. You can read more about pressure ulcers and bed sore litigation below.
How do pressure ulcers happen?
Bed sores occur when there is too much pressure on the skin, for too long. This reduces the blood flow to that part of the body, which causes the tissue to become damaged and even die.
Imagine being in a long meeting where you are sitting in a chair for hours on end. You start feeling pressure and need to move. Now imagine you can’t move. The pain and pressure worsen. Eventually, the pressure wears a hole through your flesh. That is how a pressure ulcer happens.
Generally, nurses must move patients that are unable to move themselves so that pressure sores are avoided. Other skin care preservation measures are taken as well. When a nurse fails to regularly turn a patient, that nursing negligence can cause a bed sore.
Who is at risk for pressure sores?
Individuals who are bed bound, have spinal cord injuries, poor nutrition or conditions affecting blood flow like diabetes are most at risk for pressure sores.
Where do pressures sores usually form?
The most usual places to find a pressure ulcer are bony parts of the body, such as shoulder blades, ankles, tailbone, heels and hips. It is important for the patient, or their caregiver, to recognize early signs of a bed sore, as this condition can worsen quickly.
How are pressure sores treated?
These injuries are often incredibly painful and can be difficult to treat if not caught early. Once a pressure ulcer has developed, treatment depends on severity. The severity of the injury is categorized in stages:
- Stage 1 – intact skin
- Stage 2 – partial thickness skin loss
- Stage 3 – full thickness skin loss
- Stage 4 – full thickness skin and tissue loss
- Unstageable Pressure Injury
- Deep Tissue Pressure Injury
For more detailed information on staging a pressure ulcer, see The National Pressure Ulcer Advisory Panel’s article on staging pressure injuries here: http://www.npuap.org/resources/educational-and-clinical-resources/npuap-pressure-injury-stages/.
Treatment can be as simple as antibiotic ointment or as serious as surgical debridement and wound vacuums.
If not treated timely and appropriately, complications can arise, such as a bone or joint infection.
Can bed sores be prevented?
Yes! Serious bed sores are almost always preventable. That is why CMS considers them to be “never events” – they should never happen. Usually, pressure sores are the result of medical malpractice, and specifically, nursing negligence.
Prevention is key. For those individuals living at home, and can care for themselves, this may seem an easy task – maintain good hygiene, keep skin clean, dry and protected, check problem skin areas daily, and maintain good nutrition and hydration. However, when a person is hospitalized for an extended period, or in a rehab or nursing facility, much of their care is left up to nursing staff. Many hospitals have in place wound care policies that are designed to prevent pressure sores. Some key factors include:
1. Risk assessment. Consider bed bound and chair bound individuals at risk for pressure sores. Use a risk assessment scale upon admission. Repeat at regular intervals or with changes in condition and develop a plan of care based on these risks.
2. Skin care. Inspect all of the skin upon admission, and at least daily. Assess pressure points such as heels, elbows and buttocks, cleanse and moisturize the skin frequently.
3. Nutrition. Consider that some hospitalized individuals are at risk for malnutrition, and refer them to a registered dietician, assess weight changes, provide nutritional support.
4. Repositioning and Mobilization. Patients at risk for bed sores should be turned and repositioned frequently. The care provider should avoid positioning the patient on body areas with bed sores developing, and devices such as breathable dressings and foam cushions should be used.
5. Education. The patient and family should understand the risks of developing a pressure ulcer as well as ways to prevent them.
Nurses and nurse aides are responsible for ensuring that the patient does not suffer pressure ulcers. If a bed bound patient residing in a long-term care facility suffers a serious pressure sore, it is most often a result of the staff’s failure to follow wound care policies and procedures.
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If you, or a loved one, suffered a serious pressure ulcer, contact Hoffer & Sheremet today for a free consultation and learn if you may have a medical malpractice or nursing negligence claim that entitles you to compensation.