DID YOU KNOW that Bedsores, which are also known as Pressure Ulcers or Decubitus Ulcers, are preventable and can be avoided with proper screening, early detection and staff involvement?
Who is at risk of a bedsore? Unfortunately, bedsores most often develop when a patient is admitted to an institutional setting, i.e. a hospital, nursing home or rehabilitation center. Older and infirm individuals are at greater risk if they have decreased mobility, spend long periods in bed or a wheelchair, cannot move certain body parts without help, have fragile skin, are incontinent, have poor nutrition and hydration, or suffer from physical conditions that affect blood flow, such as diabetes and heart disease.
Physicians and Nurses use what is known as the Braden Scale for predicting the Pressure Sore Risk of an individual. The scale was developed to assess and document a patient’s risk for developing pressure injuries in a hospital or long-term care facility. There are six subscales within the Braden Scale that measure elements of risk: (1) sensory perception; (2) moisture; (3) activity; (4) mobility; (5) nutrition; and (6) friction or “shear.” Each subscale is assigned a number between 1 and 4 (except friction/shear, which only goes from 1 to 3). The numbers assigned to each subscale are then added up. The lower the total number, the higher the risk is for developing an acquired ulcer or injury. Therefore, a total score of 9 or less is Severe Risk; total score of 10-12 is High Risk; total score of 13-14 is Moderate Risk; total score of 15-18 is Mild Risk.
Where are bedsores typically found on the body? They develop on the bony parts of the body that have little padding of muscle and fat, such as the back or sides of the head, tailbone, buttocks, shoulder blades, hips, heels and elbows. Any part of the body that presses against the surface of a firm mattress or wheelchair for a prolonged period of time is in danger of developing a bedsore.
Here’s why: the prolonged pressure temporarily cuts off blood supply to tissue, which can begin to die from lack of oxygen within just a few hours. While prolonged pressure is essentially the main cause of a bedsore, moisture, poor nutrition and circulation are contributing causes. Excessive moisture as well as skin irritants like urine and feces, which may be due to poor nursing care, may also contribute to the formation of bedsores.
What are the Stages of Bedsores? Caregivers know, or should know, that the best way to deal with bedsores is to prevent them in the first instance. Good care demands that the patient be turned on a regular basis and cleanliness (including the cleaning of the patient due to urine or feces) is essential. Oftentimes a bedsore develops because the caregiver is careless, e.g., does not turn or move the patient often enough or fails to clean the patient. Typically, the bedsore begins as a small, sometimes painful, red mark and can rapidly develop into a Stage II (open sore, scrape or blister), Stage III (breakdown of skin down into the fatty tissue and has crater-like appearance, or Stage IV (sore extends into the muscle, tendons, ligaments and as far as bone). Family and friends visiting with their loved one at a hospital or nursing home should also look for these dangerous skin ulcers and report them to the attending physician and nurse and document them by taking photographs at any stage. In its initial stage, a bedsore may not appear serious. It may begin with what appears to be a minor red mark in an area of the body that is continuously making contact with surfaces, such as a bed or wheelchair. When the sore finally opens, it is often too late to prevent further damage, and can be devasting for the patient and their family. By this time the skin is broken down so much that the underlying tissue, and sometimes, the bone itis exposed.
What are the complications from Bedsores? Infections are common once bedsores reach Stages III or IV. Infections can be deadly, especially to elderly patients who already may have a compromised immune system. These wounds must be dressed appropriately and regularly cleaned. Additionally, the patient may need to take antibiotics to fight an impending infection. When not treated in a proper and timely manner, pressure sores can lead to severe infection (osteomyelitis, gangrene, sepsis), amputations, a general decline in overall health, unnecessary emotional anguish and painful discomfort, and even death. The most common way to measure the severity of bedsores is by the depth of soft tissue damage.
Legal responsibility – It is critical to monitor the care your loved one receives. Bedsores are avoidable, especially when the health of your loved one is being managed by healthcare providers. In addition to claims of negligence and medical malpractice, specific statutes have been enacted to protect patients:
- New York Public Health Law § 2801-d provides a private right of action to residents of nursing homes who have been injured as a result of the nursing home depriving a resident of certain rights and benefits provided by state and federal law. A cause of action under this statute may be brought separately from a negligence or medical malpractice claim.
- New York Codes, Rules and Regulations – 10 NYCRR § 415.12 (c)(1)states: Pressure sores. Based on the comprehensive assessment of a resident, the facility shall ensure that: (1) a resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable despite every reasonable effort to prevent them; and (2) a resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing.
The law firm of Sanocki Newman & Turret, LLP has been successful in litigating cases involving bedsores. If you are the spouse, child, or parent of a family member who was injured or has died as a result of bedsores, you can seek compensation for pain and suffering of your loved one, as well as economic loss, which you and your other family members may be entitled. Please contact us for a consultation at (212) 962-1190 or email us at info@sntny.com