How to Prevent Pressure Sores

The word “bedsore” does not necessarily seem like it implies a life-threatening condition. To some, it seems like a harmless problem that implies a minor irritation, but this is far from the actual truth. “Bedsore” is a benign word used to describe what can become a very dangerous infection.

Bedsores are not just a moderate condition that someone develops from spending too much time in bed. Instead, they can be a critical sickness that can kill people. Nursing homes have a legal obligation to act to prevent their residents from developing bedsores.

Bedsores actually have another name that is closer to capturing the seriousness of this condition. They are also called pressure ulcers. They result from when the skin breaks down after being pressed against one surface for too long. This post describes exactly how nursing home residents can develop what may progress to a deadly infection. To discuss your loved one’s specific situation, consult with a nursing home neglect attorney near you.

Lack of Mobility Puts Residents at Risk of Pressure Ulcers

Pressure ulcers happen because the skin and tissue have been subject to pressure for a prolonged time. The skin may lose some of its epidermis and the tissue beneath it when the condition worsens.

Pressure sores often develop when a nursing home resident remains in one position for too long without moving or being moved.

Such a painful and unhealthy situation can arise when:

• The resident lies in bed for prolonged periods and develops bedsores on the sections of their bodies pressed against the mattress.
• The resident’s heel rubs against the footrest of their wheelchair when they are sitting for an extended period.
• The resident’s buttocks can become infected when they are sitting for an extended time.

Pressure ulcers will always begin with some redness and irritation. The skin may already be in a weakened state because the elderly resident is dehydrated or malnourished. Nursing home neglect puts seniors at risk in more ways than one. Here, the skin can become dry, leaving it at higher risk for irritation since the staff is not properly hydrating the resident and checking the skin.

In serious cases, nursing homes not only fail to prevent the redness from developing in the first place, but they will then do nothing as skin irritation progresses to an open sore and deep tissue injury that could eventually lead to sepsis. Regrettably, these nursing homes will do nothing until the infection has progressed to a deadly stage,

Pressure Ulcers Are Unfortunately Common in Skilled Nursing Facilities

Pressure ulcers are far too common in nursing homes. What makes this frequency even more distressing is that bedsores do not have to be as seemingly routine as they are. By following federal regulations and doing their jobs, nursing homes can prevent many of these pressure ulcers from even forming. Certainly, they can keep a large share of these bedsores that happen from growing to become serious infections. The federal government and states commonly fine nursing homes for poor prevention and care for pressure ulcers.

Estimates of the number of nursing home residents who develop pressure ulcers vary. Some surveys state that between two to 28 percent of seniors at nursing homes will have a pressure ulcer each year. Another survey shows the prevalence rate at 7.5 percent. Most people can agree that the rate of pressure ulcers directly correlates to the quality of nursing home care in the country or lack thereof.

As these skilled nursing facilities take the “skilled” part out of their care in the name of profits, their residents are more at risk of negligence-based injuries. As you will see below, pressure ulcer prevention takes time and staff to ensure that they are not sitting or lying in one place for too long. However, nursing homes cutting back staff to boost their bottom lines and please their investors, a direct threat to the well-being of residents who depend on these employees for even the smallest activities.

Nursing Homes Have a Legal Requirement to Prevent Pressure Ulcers

First, allow us to explain what nursing homes’ legal obligations are when it comes to pressure ulcers. Like every other part of daily life at nursing homes, the facilities have detailed and strict regulations that they need to follow.

Rules regarding pressure ulcers are part of the overall “Quality of Care” regulation found in 42 CFR 483.25. Specifically, pressure ulcers are part of a subsection of the rule entitled “skin integrity.”

A nursing home’s obligations are twofold:

• Nursing homes have a legal obligation to prevent pressure ulcers from occurring unless the resident’s condition makes them unavoidable.
• Residents must receive the necessary treatment to prevent infection and to keep new pressure ulcers from developing.

Designing and Following a Care Plan Helps Prevent Pressure Ulcers

Preventing pressure ulcers all begins with the nursing home developing a care plan. Nursing homes have a legal obligation to develop a care plan for each resident. This plan is should assess whether the resident is at risk for pressure ulcers. This individualized assessment depends on the resident’s health.

The nursing home staff must be very careful when the resident cannot walk and spends practically their entire day in their bed or a wheelchair. Both of these are the prime places where seniors can develop pressure ulcers. Accordingly, their prevention plan must take special measures to ensure that these do not lead to skin injuries.

Shift Residents’ Positions

Pressure injuries develop when nursing home residents are in one position for an extended time. The problem is that most nursing home residents are not fully mobile. In fact, over 70 percent of them spend significant parts of their day in wheelchairs. Many of them cannot shift their own positions without help.

The best thing is for nursing home staff to get residents moving as much as they can. However, that is not always possible or safe. As such, caregivers need to help residents shift their positions as often as possible to prevent prolonged pressure on any one area of the body.

The accepted standard is that nurses must help the resident shift position every two hours. Otherwise, the skin can rapidly become inflamed and break down. Unfortunately, far too many nursing homes fail to follow this basic tenet.

Protect Bony Areas From Prolonged Direct Contact With Hard Surfaces

Residents are most susceptible to developing pressure ulcers in the bony areas of their body, including:

Usually, the best way to prevent these bony areas from developing pressure ulcers is through foam and padding that keeps them from directly contacting a hard surface. Pillows and foam wedges are some of the most effective tools against bedsores. Beyond that, repositioning and rotation will minimize the amount of prolonged contact bony prominences have with harder surfaces.

Check Skin Often

Nursing home staff should continuously check residents’ skin for areas that could be red or discolored. After they initially assess the resident’s risk for developing pressure ulcers, staff should periodically reevaluate after examining the senior’s skin condition. They should particularly close attention to the bony areas listed above. If an examination reveals a bedsore, the nursing home should adjust the resident’s prevention and care plan.

While there is no hard-and-fast rule that determines how often a nursing home should evaluate a resident’s condition, the answer to this question should be as often as necessary to prevent pressure ulcers. The higher the resident’s risk of pressure injuries, the more frequently nursing home staff should evaluate their condition. If nursing homes fail to follow the pressure ulcer prevention and care plan, they can be legally responsible if your loved one is injured.

Ensure Proper Nutrition and Hydration

As noted above, the elderly are more vulnerable to pressure ulcers when they are dehydrated. As such, one of the first steps to preventing pressure ulcers is ensuring that the senior drinks and eats enough. Staff needs to continuously monitor residents to ensure that they are consuming enough water. In addition, the nursing home must strictly follow federal dietary regulations, ensuring that the resident does not lose a certain percentage of their body weight. Good fluid intake and nutrition will help build up the body’s defenses to skin irritation.

Use Special Mattresses

Another way of preventing pressure ulcers is for the nursing home to use a special mattress that reduces the risk. Here, the facility should place the resident on a pressure-relief mattress.

A nursing home can provide for a softer surface

• The nursing home would most often let some air out of the mattress, making it less firm. The softer the mattress, the less of a chance that it would irritate the resident’s skin.
• There are special foam mattresses that can help prevent bedsores. They work by spreading the pressure over a larger surface, reducing the amount of pressure in one place that comes directly into contact with the senior.
• Alternating pressure mattresses are advanced technology that can reduce irritation. These mattresses automatically change the pressure in different chambers of the mattress and so relieve pressure on different parts of the body in an alternating fashion.

While technology can prevent pressure ulcers, we would sound a few notes of caution:

• Nursing homes need to invest the money in the right technology to prevent pressure ulcers. However, many of them try to get away with spending as little as possible on their residents. If nursing homes do not even invest in an adequate number of nurses and aides, they are likely not spending on medical equipment.
• Even with advanced beds, nursing home employees still must rotate residents.
• Many pressure ulcers happen in wheelchairs. The technology to prevent bedsores from contact with wheelchairs is not as advanced as that used in mattresses if it even exists at all.

Monitor the Quality of Care

Since pressure ulcers often result from nursing home negligence, it follows that nursing home administrators and supervisors need to track the quality of care at nursing homes closely. It does not take very long for the conditions that can lead to a dangerous pressure ulcer to develop. Once a pressure ulcer progresses to stages 3 and 4, it is often too late to prevent long-term damage.

The potential for permanent damage is why the process matters every bit as much as the individual day-to-day care decisions. Nursing home leadership needs to provide enough staff and ensure they follow care plans.

You Can File Negligence Lawsuits for Pressure Ulcer Injuries

In most cases, if your loved one has become sickened or dies from bedsores, you can file a negligence lawsuit against the nursing home that failed to care for them properly. All the above steps that we described concerning the prevention of pressure ulcers are how reasonable nursing homes care for their patients. Anything less can breach the nursing home’s duty of care and create grounds for a lawsuit. Pressure ulcers often result from nursing home neglect, which is a form of abuse.

As you can see, pressure ulcers usually happen because the nursing home has not properly discharged the duty that they assumed when they admitted your loved one. In most cases, they have failed on two fronts. First, their negligence allowed the pressure ulcer to develop. Second, their failure to properly care for the wound permitted it to progress to the point of a life-threatening infection. Working with a nursing home negligence lawyer, you can hold the facility legally responsible for its failures.

Your loved one or your family deserves financial compensation for any injuries or fatal injuries your loved one suffered. While many pressure ulcer lawsuits end up as wrongful death cases, you can even sue when your loved one survived and eventually recovered. Always learn about your options from an experienced nursing home negligence attorney. Contact Brauns Law Accident Injury Lawyers, PC to learn more about your legal options.