How Do Nursing Homes Prevent Bed Sores?
Nursing homes are under pressure to prevent bedsores or pressure ulcers, as they can cause a great deal of pain and suffering for patients. Pressure ulcers or sores can worsen if the nursing home staff members fail to address them immediately.
At Rosenfeld Injury Lawyers, LLC, our personal injury attorneys understand nursing homes’ pain to prevent bedsores. If you have a loved one who has suffered from pressure sores, please contact Chicago bedsore attorneys today at 855-947-8723 for more information and get a free legal case review.
Nursing Home Residents at High Risk of Pressure Wounds
Pressure ulcers are a common problem for nursing home residents. They can occur when pressure is on the skin for an extended period. For example, the pressure can happen from sitting in the same position for too long, being bedridden, or wearing restrictive clothing.
There are several things that nursing homes can do to prevent pressure ulcers from occurring. One of the most important is to move residents around frequently to not sit in one spot for too long.
Another solution is to make sure that the resident's bed is adjustable to be raised and lowered as needed. The staff should also be sure to regularly check the skin for any signs of redness or swelling, indicating that a sore is developing.
Pressure Sores Nursing Home Reports and Statistics
According to the CDC, nursing home residents, particularly those with dementia or Alzheimer's disease, are less likely to show signs of bedsores compared with other residents. However, in many cases, the resident cannot tell staff members when they are in pain.
The National Center for Health Statistics reports that most pressure ulcers are found on the tailbone, ankles, heels, and hips. The most common sores that develop in nursing homes are bed sores or pressure ulcers.
Nursing home residents can develop bedsores from long periods of sedentary or bedridden, which can be detrimental to the patient’s health.
A systematic review shows that most nursing home residents will develop one to three bedsores during their stay, despite receiving adequate treatment.
Nursing home residents have an increased risk of developing ventilator-associated pneumonia, requiring care in intensive care units. In addition, the CDC adds that bedsores are often linked to other common illnesses among elderly individuals, such as urinary tract infections and blood clots.
Bedsores Causes and Nursing Home Neglect
When a nursing home resident develops wounds caused by sores, it might be due to nursing home neglect.
Nursing facility neglect occurs when a nursing home and its personnel fail to provide adequate care, resulting in significant pressure injuries for a patient.
Bedsores can form as a result of three factors:
Prolonged pressure between the bone and the surface of a bed, chair, or wheelchair may occur while lying or sitting for a lengthy period. Blood flow is reduced or halted due to this, depriving the skin's tissue of oxygen and other nutrients.
An elderly resident who requires assistance with daily activities, such as bathing and incontinence care, may sit or lie in one position for an extended period, especially if nursing home workers do not check on them often. However, this might put too much strain on one area of their body and cause a decubitus ulcer.
Shearing occurs due to the movement or rubbing against two surfaces (bedsheets, well-designed support surfaces, or mattresses). Isolating a few people in a nursing home might be harmful. When their skin moves one way while their bones move in another, Shear may cause injury to the residents' skin.
Shear may occur in nursing facilities when:
- Moving residents onto their side to prevent bedsores may cause the skin on the back to move, leading to personal injury.
- Residents sleep on their sides, causing the skin on one body area to move.
- Residents are not turned over often enough.
Shear can be avoided by placing nursing home patients’ heads at a 30-degree angle (or lower). In addition, residents should be lifted rather than dragged.
Bedsores caused by friction are common among nursing home residents, who are more susceptible to skin damage owing to their age.
The skin's surface is rubbed against an object or other surface, such as carpeting. For example, friction can occur when a person slides out of their chair and drags their buttocks along the ground. When residents are moved between surfaces (from a bed to a wheelchair), friction may also happen.
In addition to these traditional methods, nursing home employees may use a variety of creative approaches to decrease friction. For example:
- Placing strips of material, such as foam or cloth, underneath the resident's skin to provide padding.
- Use special linens that can be removed and washed often. These might include T-shirt sheets made specifically for patients who use catheters.
- Keeping the skin clean and dry to avoid excess moisture
- Caring for patients in a prone position whenever possible, like positioning them on their stomachs. This position reduces friction because it limits movement compared to turning the patients onto their sides.
- Offering patients frequent sponge baths. These might be more effective and inflict less discomfort than simply wiping with a towel after each use.
When nursing home employees provide effective pressure relief and turn residents over frequently, sores can heal before they even form. Nursing homes can prevent bedsores by providing these basic procedures.
Other common causes that nursing home pressure ulcer patients experience include:
- Skin breakdown from urinary and fecal incontinence.
- Radiation burns from repeated exposure to radiation.
- Frostbite from a lack of circulation.
- Contact Dermatitis from a chemical irritant on the bedsheets, such as bleach or an iron-on patch.
- Water beds and over-washing of linen can cause dermatitis.
- Heat Rash caused by moisture buildup around the patient's skin.
- Blisters caused by friction from wheelchair and bed linens and clothing
Pressure Sore Signs and Symptoms
Pressure sores usually present as one of two types: open or closed wounds. They can also occur to varying degrees, including:
- Stage 1: redness or tenderness in the skin due to constant pressure
- Stage 2: skin damage with partial loss of outer layer
- Stage 3: full-thickness skin loss involving damage to muscle and bone tissues
- Stage 4: extensive tissue and nerve damage. May include exposed bones and tendon or joint surfaces.
Nursing Home Neglect
Nursing home neglect is the failure to provide a nursing home resident with the necessary care and services to ensure their well-being. This lack of care can lead to pressure ulcer development.
A few forms of nursing home neglect that lead to bedsore development include:
- Poor hygiene
- Over/Under medication, resulting in prolonged durations spent lying down.
- Lack of adequate knowledge on pressure ulcer prevention tips
Keep an eye out for symptoms of bedsores, such as:
- Tenderness on the skin around bony prominences (heels, ankles, or hips) increases as pressure is applied.
- Reddened skin may indicate the early stages of a pressure sore.
- Swelling or skin that looks distorted, such as one side being redder than the other.
- Skin with a shiny appearance and cold to the touch.
Notify your loved one's healthcare provider if you notice any of these symptoms.
Bedsore Risk Factors
Limited mobility is the most common risk factor for bedsores. Pressure sore is a significant concern caused by excessive pressure, friction, and shear if an older person has difficulty moving around independently.
Other risk factors include:
Elderly and children are more likely to develop bedsores.
An older person can have difficulties with bladder function, which may result in being incontinent with urine. It can lead to bedsores around the hips, tailbone, shoulders, and ankles.
Disease or Personal Injury
- Diabetes: Chronic poor blood flow leads to a higher risk of developing pressure sores.
- Cancer: Decreased immunity can result in sore development when wounds like radiation burns go untreated.
- Skin Conditions: Eczema, psoriasis, or other chronic skin conditions place patients at very high risk for bedsores.
- Spinal Cord Injuries: Bedsores are the most common type of ulcer that people with spinal cord injuries get. It usually results in a lack of sensory perception.
- Heart Disease: Poor circulation, high blood pressure, and respiratory disease can lead to bedsore development.
- Multiple Sclerosis: Patients with this degenerative condition have decreased sensation in their skin, making them more susceptible to pressure injury during times of reduced mobility.
The body needs proteins, vitamins, and minerals to heal properly. When a person isn't getting enough of these nutrients, essential healing can be delayed or prevented altogether.
Vitamin C deficiency may lead to the development of bedsores. It is why some healthcare professionals recommend vitamin C supplements in conjunction with topical wound care products for pressure sore treatment.
Other Health Complications
Poor general health or a weakened immune system makes a person more susceptible to bedsores.
Mental impairment is a major factor for bedsores in nursing facilities. Nursing home staff members are required to make daily assessments to determine if a patient needs proper care because of their condition.
If the mental impairment is severe enough that they can't recognize or communicate pain, then bedsores may develop without any obvious signs of skin damage.
To prevent common bedsore causes and risk factors, nursing home personnel should pay particular attention to at-risk patients. Caretakers should perform head-to-toe skin exams on individuals with mobility problems on a regular basis, as well as reposition them if ICU is necessary.
How to Prevent Bedsores and Pressure Ulcers Among Nursing Home Residents
The causes mentioned above of bedsores are prevalent, and most can be treated with a minimum of effort. Staff at nursing homes are responsible for following established processes, detecting signs of bedsores in residents, and treating them as soon as possible.
Bedsores are a serious problem in nursing homes. It's critical to take precautions against bedsores in nursing homes.
Nursing homes make sure they do the following regularly:
Maintaining Good Hygiene
Proper hygiene can prevent bedsores. The risk of bedsore development increases if the skin is dry, so staff should carefully monitor bath time to ensure no parts are missed.
Caregivers should pay particular attention to armpits, groin folds, and other sensitive spots that may become irritated or inflamed.
Since skin is the body's largest organ, nursing home staff should pay attention to overall health. For example, if a resident has another condition that puts them at risk for bedsores, then they should let staff know about it as soon as possible.
Maintaining Proper Nutrition
It's also important to maintain proper nutrition to avoid malnutrition. For example, patients who cannot button their own shirts or put on their own shoes should be fed with a fork.
Some residents may need assistance from nursing home staff to eat. In addition, bedridden patients should receive a nutritious diet to maintain their strength and improve healing times.
Monitoring the Skin in Residents With Limited Mobility
Residents who cannot move should be turned regularly and monitored for bedsores in nursing homes. Staff members can place clean towels under the patient and check the skin for any noticeable changes.
Caretakers should also work with patients who have poor circulation, which can cause blood to pool and lead to bedsores.
Elevating the Feet of Bedridden Patients
Bedridden patients need proper care in nursing homes. For example, they may require extra pillows under their feet to help improve blood flow and avoid bedsore development.
If the patient cannot move, then nursing home employees should elevate their legs with pillows or rolled towels at least twice a day.
Providing Safe Environment
Nursing homes must provide a safe environment where residents can live without developing pressure sores. Some simple measures to ensure patient safety include:
Make sure bed linens and clothing are smooth and wrinkle-free. If the patient requires a hospital gown, caretakers should help them change it regularly.
Well-designed support surfaces can protect a resident from developing bedsores. These surfaces should evenly distribute the patient’s weight and prevent pressure on sensitive spots.
Monitoring the Risk Factors
They should monitor the risk factors, keep a close eye on patients, and follow established procedures. Repositioning is very important, but staff members should take other steps to ensure a bedridden individual remains comfortable and free from bedsores.
Nursing homes need to carefully monitor their residents' skin for changes that indicate bedsore development. Nursing home employees can prevent this serious condition by carefully watching the signs.
Moving Patients Regularly Even If They Can't Move on Their Own
Nursing homes should move residents who can't regularly move to reduce pressure points and ensure patient safety with a slippery floor.
If the patient is in a wheelchair, nursing home staff members must reposition them every two hours to avoid bedsores. Dorsal decubitus ulcers can occur when a person remains in one position for long periods.
If the patient is bedridden, nursing home employees should turn them over to their side at least every four hours. If this isn't possible, they should ensure that the patient's head and feet are properly positioned.
Evaluating Patients Who May Be at Risk for Pressure Sores
If a patient is bedridden, nursing homes should regularly evaluate their skin and look for bedsores. If they notice redness or any signs of deterioration with the skin, they should seek professional medical advice.
Patients with diminished sensation may not tell if they have developed pressure sores, which should be monitored closely by nursing home staff. Patients who do not have a caregiver at the facility should also receive special attention from nurses and doctors to ensure they don't develop bedsores.
However, nurse managers should also be aware that bedsores can occur even in well-managed nursing homes if the patient does not have good circulation. If they are at risk or already have developed bedsores, nurses need to know how to treat them.
If you suspect your loved one is suffering from bedsores at a nursing home, contact an attorney specializing in nursing home abuse to discuss your case and determine if you have grounds for a lawsuit.
Treatment of Bedsores in Nursing Homes
A wound care team or a general health care provider might manage nursing home bedsores, depending on the severity of the sores.
Nursing home bedsores should be assessed and treated by a wound care team or general health care provider as soon as possible.
When the first signs of bedsore appear, nursing homes should provide residents with extra padding to prevent further injury to the skin. If the sores don't heal on their own after this, treatment may include removing the dead tissue and debriding (cleaning) or packing the wounds.
Specific treatments will depend on the location of the bedsores and the severity of the wound due to restricted blood flow to the area.
Pressure injury (bedsore) treatment might also include:
- Forceful wound dressings and debridementunder general anesthesia or conscious sedation, in which you receive medicine that makes you relaxed and drowsy with an analgesic agent to keep pain under control
- Cyclical negative pressure therapy is a form of treatment that may heal venous leg ulcers or large wounds by increased blood flow.
- Physical or occupational therapy sessions—which might include exercises for joints and muscles
- Dietary changes—including more calories—help build muscle mass and prevent additional weight loss.
- Removing pressure on the wounds using a mechanical lift or relocating residents to another part of the nursing home.
- Pain medication.
When nursing homes fail to provide treatment for bedsores, residents may need to be transferred to a long-term care facility. If bedsores don't heal after this, the patient might need surgery or amputation. In addition, they will most likely experience additional pain and discomfort.
Legal Compensation for Nursing Home Abuse Bedsores
Most families will not be able to file a claim, gather evidence, and then pursue the legal procedure if they do not have an experienced lawyer on their side. It might be quite tough to win a case if you don't employ expert legal help.
Understanding the causes, prevention, and treatment of bedsores can help you hold negligent parties accountable for failing to prevent the condition.
If the nursing home wants to settle out of court, an attorney can also assist you by navigating the procedure. Your lawyer will be able to read the agreement and let you know if it's fair, as well as help you negotiate a better deal. After that, whether you want to go to trial or settle out of court is entirely up to you.
Nursing homes should not be allowed to get by with mistreatment and neglect. Furthermore, after elder abuse and neglect, it becomes difficult for some families to pay their medical bills independently.
Hiring a lawyer can help you get the maximum feasible compensation and justice for yourself and your family.
Hiring a Chicago Nursing Home Abuse and Neglect Lawyer
If you or a loved one has suffered from nursing home abuse, neglect, or mistreatment, the Chicago attorneys at Rosenfeld Injury Lawyers LLC can help.
Our legal team has years of nursing home abuse and neglect experience and will fight to get the maximum compensation for your damages.
If you are not sure if you have a case, give our legal team a call today at (888) 424-5757. Our attorneys will go over your situation for free to determine whether or not you should file suit.
Nursing homes should treat their patients with dignity and respect. When they neglect to perform good nursing care, the victims and families deserve financial compensation for their suffering.
Our Chicago injury lawyers will fight to help you recover damages and then put that money into a trust fund for your future medical needs.
In addition, you can rely on our Chicago elder abuse attorneys to get professional representation on your side and get a free legal case review to discuss a nursing home abuse lawsuit on a contingency fee basis.
All confidential or sensitive information you share with our law firm remains private through an attorney-client relationship.