Preventing Pressure Sores in Nursing Home Residents
A decubitus ulcer, commonly known as a pressure sore or bed sore, is one of the most common acute health issues suffered by nursing home residents, and also one that is frequently preventable. These ulcers are particularly prevalent among the elderly and those with limited or impaired mobility.
How Pressure Sores Develop
Generally, a pressure sore develops due to prolonged pressure on the skin. For this reason, sores most often develop on parts of the body that frequently remain in contact with a bed or chair.
The prolonged pressure reduces blood flow to the area, leading to skin breakdown. If left untreated, a pressure sore progresses through four main stages:
- Stage 1: Non-Blanchable Redness. The skin appears red or discolored and does not turn white when pressed. The patient may report pain, itching, or discomfort.
- Stage 2: Partial-Thickness Skin Loss. The outer layer of skin (epidermis) and possibly part of the second layer (dermis) are damaged. The ulcer appears as a shallow open wound, blister, or abrasion. Pain and tenderness are common.
- Stage 3: Full-Thickness Skin Loss. The ulcer extends into deeper layers of skin, affecting the fat layer (subcutaneous tissue). It appears as a deep crater-like wound. Yellowish dead tissue (slough) may be present.
- Stage 4: Full-Thickness Tissue Loss. The ulcer extends deeper than the skin and fat layer into muscle, tendon, or bone, which increases risk of infection. Large amounts of dead, necrotic tissue (eschar) and slough may be present. Severe pain, foul odor, and signs of infection are common.
Alternatively, a decubitus ulcer may be described as “unstageable.” This means the wound is covered by thick dead tissue or slough, making it impossible to determine the depth of the wound until tissue is removed.
How nursing homes can prevent pressure sores
While decubitus ulcers are common, in most cases, they are also preventable. Timely and appropriate medical care is extremely important to prevent a pressure sore from reaching the later stages. However, absent adequate treatment, pressure sores can lead to even more severe medical conditions including infection, sepsis, organ failure, or death.
Federal nursing home regulations state that no patient should develop a decubitus ulcer unless such development is “unavoidable.” 42 C.F.R. § 483.25(b)(1).
Upon admission to a nursing home, nursing staff are required to assess the patient’s risk of developing a skin condition, such as a pressure sore. Based on the patient’s level of risk, the nursing staff must implement reasonable measures to minimize the likelihood that the patient develops a pressure sole while at the facility.
One of the most important and effective measures to prevent the development of a pressure sore is maintaining a regular turning and repositioning routine. This requires the nursing staff to evaluate the resident at scheduled intervals and to ensure that no single area of skin remains under pressure for a prolonged period of time.
If a patient is at a particularly high risk of developing a pressure sore, additional measures may be required including a specialized dietary plan, specialist consultation, and prescription medications, to name a few.
We hold negligent nursing homes accountable
When nursing homes fail to take appropriate steps to prevent pressure sores, patients can be seriously harmed. Our job is to pursue accountability. If you or a loved one suffered an injury while residing in a nursing home, contact Walsh Woodard today at 860-549-8440 to schedule a free consultation.
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