Pressure wounds (also called pressure ulcers or bed sores when they first start) are nasty wounds that can kill a patient if they get out of control. They are usually preventable with good care. A patient who suffers a serious injury or death from one or more pressure wounds has good cause to investigate a potential medical malpractice claim against the hospital or nursing home where it happened.
As the term implies, pressure wounds happen with pressure. The skin and underlying tissue become wounded by loss of blood supply. This happens usually over a “bony prominence,” where there is little fat or muscle to cushion the skin. Prime areas for pressure wound formation in people lying down are the heels of the feet and the sacrum (tail bone), and in sitting people, the buttocks just outside the ischia, the bones at the bottom of the pelvis. Pressure wounds can happen with pressure alone or pressure combined with friction and/or shear.
Pressure wounds are preventable (or “avoidable” in the industry terminology) when a facility fails to perform one or more of the following:
- assess pressure wound/pressure ulcer risks;
- plan and provide care to minimize risk;
- apply recognized practice standards;
- implement, document, and evaluate effectiveness;
- change the care plan if it isn’t working.
Standards for quality care in the prevention and treatment of pressure wounds/ulcers can be found in these organizations’ web sites:
- National Pressure Ulcer Advisory Panel (NPUAP)
- Wound, Ostomy, Continence Nursing Society (WOCN)
- Agency for Healthcare Research and Quality (AHRQ), which publishes this book that is the basis for the NPUAP standards:
Preventing Pressure Ulcers in Adults
- Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Guidance to Surveyors for Long Term Care Facilities
If you have an immobile family member in the hospital, the hospital needs a regular routine for turning them to prevent sores that turn into gaping wounds that can kill. Find out what the schedule is and enforce it. Read more…
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