Pressure Ulcer in Nursing Home Statistics
At first, pressure ulcers appear as small red marks on the skin and may not seem to be serious. However, if left untreated, pressure ulcers can be very uncomfortable. The National Nursing Home survey reveals that bedsore is a serious problem in many nursing homes and is a leading cause of infections, skin cancer, and even death.
However, many people are unaware that a pressure ulcer can be avoided. Since pressure injuries are generally prevented with proper care, it may indicate nursing home neglect. The staff’s failure to recognize and address pressure ulcers in the early stages indicates nursing home abuse.
The experienced personal injury attorneys at Rosenfeld Injury Lawyers, LLC understand the complex nature of bedsores cases. We're here to help you get the compensation you deserve for your injuries.
Contact our nursing home abuse lawyers at (888) 424-5757 (toll-free phone number) or use the contact form today for immediate legal advice and schedule a free consultation. All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.
Nursing Home’s Effect on Pressure Wounds
A pressure ulcer, also known as bedsore, is a common and potentially fatal complication for elderly patients in nursing homes. In addition, bedsores can develop quickly, often within two hours of the patient becoming immobilized. These sores can be excruciating and often lead to infections and serious skin problems.
If not treated immediately, they can progress to serious medical conditions. Therefore, nursing home residents must receive the highest standard of clinical practice guidelines to prevent pressure ulcer development.
Unfortunately, health care research reveals that many nursing homes fail to adhere to standard clinical practice guidelines. Contacting medical professionals is the first way to tackle bed sores.
Have you or a loved one suffered from a bedsore while in a nursing home?
If so, you may be entitled to compensation. Our team of experienced attorneys has successfully represented nursing home abuse and neglect victims. Contact us today for a free consultation or a free legal case review.
Nursing Home Statistics on Pressure Wounds 2018-2022
Each year, the United States National Center for Health Statistics & Reports estimates that 2.5 million patients in the United States develop pressure injuries, also known as bed sores or decubitus ulcers.
A data brief of the most recent national estimates presented by the National Center for Health Statistics reveals that almost 11% of long-term care residents in the US develop bedsores during their stay. The prevalence of bedsores in nursing home residents can even reach up to twenty percent.
Another data brief presented by the Centers for Disease Control and Prevention shows that 35% of nursing home patients suffering from bedsores need immediate attention.
The pressure ulcer prevalence among nursing home residents can develop when a patient cannot move around regularly due to age, illness, or disability and results in the build-up of pressure on certain parts of the body.
The National Center for Health Statistics also reveals that individuals in nursing homes, especially those receiving mechanical ventilation, are at risk for developing bedsores because of lack of mobility, decreased oxygen delivery, and poor nutrition status. If left untreated, these sores can quickly progress from mild irritation to a life-threatening infection.
The data coming from nursing home residents with pressure injuries should be closely monitored by staff and receive immediate medical attention if any signs of progression are observed.
Pressure Ulcer Prevalence and Patient Characteristics
According to the National Center for Health Statistics, one in five nursing home residents in nursing homes who had recently lost weight were more likely to develop pressure ulcers than those who had not.
Residents who had any recent bowel or bladder incontinence showed a higher rate of pressure ulcers than those who lived on the continent. Nursing homes with high immobility residents had 11 percent more pressure ulcers than others who move around. A higher occurrence of pressure ulcers was linked to polypharmacy or taking more than eight drugs.
A study conducted by the Agency for Healthcare Research and Quality (AHRQ) revealed that over half of nursing home residents with pressure ulcers had been neglected by their caregivers.
In the study, only 22% of patients received treatment for their bed sores within a day of becoming sore, and 7% were left untreated for more than a week, ramping up the percentage of nursing home abuse.
Patients who cannot communicate due to cognitive or speech problems are at an increased risk for pressure injuries. For example, a recent study found that older patients with dementia face a greater than two-fold increase in the risk of developing decubitus ulcers compared to their non-demented counterparts.
The inability to communicate the discomfort associated with bedsores makes it difficult for these patients to receive the immediate care required. In addition, the same AHRQ study showed that patients with dementia were less likely to have their sores treated within a day of development than those who did not have cognitive impairment.
Thirty-eight percent of non-demented patients had immediate treatment within 24 hours, while only 13% of dementia patients did.
Procedural Check-up for Nursing Home Patients
A standard procedure is for the wound care team to check medical conditions, including the patients' skin, for redness and sores before admitting them to nursing home facilities.
Unfortunately, most nursing home staff members do not perform these important measures upon admission. As a result, pressure ulcers are often only discovered during a routine skin inspection, which may come several days after admission to the facility.
When these wounds are discovered, they have often progressed to higher pressure ulcers that require immediate medical treatment. In worst cases, some of these sores go undetected until they result in infections like squamous cell carcinoma or sepsis.
Pressure ulcers can also develop in ambulatory individuals who live in a nursing home. However, these patients typically do not suffer from bedsores as frequently as their immobile counterparts.
Medical Costs of Pressure Wounds
While admitted to a residential care facility, most patients cannot communicate if they have existing medical problems or conditions that increase their risk for bedsores. At the same time, their family members also fail to mention it.
Without a complete medical history, it is difficult for a facility to determine if a patient will be at risk of developing these wounds and take the necessary precautions.
According to the National Center for Health Statistics (NCHS) data brief from the Centers for Disease Control and Prevention (CDC), pressure ulcers are among the most expensive wounds to treat. In addition, if left untreated, these sores can lead to serious infections requiring extensive antibiotics or surgical procedures for immediate treatment.
It costs $21,000 per patient for pressure ulcer treatment at the initial stage and $61,000 per patient if an infection develops. The CDC also reports that the longer a pressure ulcer remains untreated, the higher the cost of care.
The development of pressure ulcers can also cause other medical complications such as sepsis and osteomyelitis (bone infection) or spreading into the joints and damaging cartilage, putting the individual in a potentially life-threatening condition.
These infections often lead to increased hospitalization costs and require additional surgery. Although these problems can affect individuals in any age group, the elderly and those with diabetes are more likely to develop osteomyelitis.
Symptoms of Pressure Ulcers in a Nursing Home
A pressure injury, also known as a bed sore, is a common problem for nursing home residents. These sores can develop when there is constant pressure on one skin area. This pressure can be caused by lying in the same position for an extended period or wearing tight clothes.
The Centers for Disease Control and Prevention considers pressure ulcers a serious medical condition requiring clinical care. Symptoms of pressure ulcers include redness, pain, swelling, and drainage. Contact the staff immediately if you notice symptoms of pressure ulcers in your loved ones living in nursing homes.
It is essential to get treatment for these sores as soon as possible to prevent them from becoming infected. The following is a list of symptoms that may indicate a bed sore:
Redness of the Skin
The most common symptom of bedsores is redness in the affected area. Typically, the skin first develops open wounds, then when this area turns black or blue, it's known as a Stage 4 pressure sore and usually requires surgery to heal.
Infected bedsores may cause the skin on the surrounding area to swell.
Pus or Drainage
Pressure ulcers infected with bacteria may leak fluid and become filled with pus. In addition, a foul odor is often associated with the drainage from these sores.
Fever, Chills, or Loss of Appetite
If your loved one has any of these symptoms in addition to redness, swelling, or pus from a decubitus ulcer, contact the nursing home staff immediately.
Causes of Pressure Ulcers
The delivery of oxygen and other nutrients to tissues depends on blood flow. Constant pressure resulting in cutting off the blood flow to the skin for more than 2 to 3 hours may result in bedsores.
In those with restricted mobility, this kind of pressure injury usually occurs in places that aren't adequately cushioned with muscle or fat and lay over a bone, such as a spine, tailbone, shoulder blades, hips, heels, and elbows.
Patients who cannot change positions on their own may be at risk for bedsores from their body weight if not repositioned once every two hours. In addition, people who lack sensory perception due to spinal cord injuries and nervous system diseases without acute care can develop bedsores very quickly.
Bedsores can also be caused by friction and shearing forces in patients who cannot move independently. This pressure is prevalent in individuals who use wheelchairs and the elderly in nursing homes.
The risk of developing pressure injuries is higher in people who have difficulty moving. For example, an elderly adult’s inability to change position while in bed makes them prone to developing bedsores. Risk factors include:
- Immobility can be associated with spinal cord injury, aging, poor health, and other medical issues. One of the risk factors for pressure ulcers is limited mobility, common among older residents in nursing homes.
- Incontinent patients are more likely to develop bedsores. The acidic quality of urine or feces kept against the skin makes it more vulnerable to cracking and peeling.
- Lack of sensory perception. Medical and physical conditions such as spinal cord injuries can cause a loss of sensation. The patient’s inability to feel discomfort and irritation leads to being unaware of signs of the need to change position.
- Malnutrition and hydration. Older adults require sufficient nutrients in their daily diets, not only for healthy skin but also to prevent the breakdown of tissues.
- Health issues that affect blood flow. Older adults are prone to health problems that affect normal blood flow. For example, diabetes and vascular diseases increase the risk of tissue damage.
Treating Pressure Ulcers in Nursing Home Residents
If your loved one has recently been admitted into a nursing home facility, check their skin frequently for redness in areas with constant pressure.
If you notice these symptoms, notify medical professionals immediately. Nursing home residents should be treated immediately for their pressure sores to prevent the wound from progressing and becoming more expensive and difficult to treat depending on the depth of soft tissue damage.
Risk Factor Assessment
Unfortunately, most patients are not assessed for their risk of developing bedsores; hence they develop an ulcer before receiving proper wound care services. Therefore, all new residents must be evaluated for risks before being admitted into a residential care facility.
The nursing home staff should also monitor these residents frequently to prevent pressure ulcers among nursing home residents.
Treatment involves giving acute care, including special bedding, using support surfaces to reposition the patient for increased blood flow, antibiotics, or surgery. Staff can prevent infection with proper treatment if the pressure is caught early.
Treatment Recommendations From Medical Foundations
Resident characteristics can help identify nursing home residents who are more likely to have pressure ulcers. Thus, the Centers for Medicare & Medicaid Services (CMS) recommends that nursing homes use a risk assessment tool to recognize those at a higher risk for bedsores. These assessments should occur before admission and then daily after the patient has been in the facility for 24 hours.
Preventing bedsores from developing requires nursing homes to ensure that every resident with limited mobility is:
- Turned at least once every eight hours
- Fed a healthy diet with adequate hydration
- Given proper nutrition and care when toileting
In addition, staff in nursing homes must be aware of the signs of bedsores and the stages of the disease. They should also be trained to check for pressure ulcers properly if a resident cannot communicate pain or discomfort. Seeking immediate professional medical advice should also be done.
4 Stages of Pressure Ulcer and Wound Care Services
Bedsores may heal in a matter of days with the application of a clinical practice guideline in the earliest time possible. Note that a system for staging pressure ulcers classifies bed sores based on their depth and damage caused to the skin. There are four pressure ulcer stages, and the type of special wound care services will depend on the assessed stage of the wound.
Familiarity with these phases can aid clinicians in determining the most suitable treatment plan for a quick recovery.
In stage 1, only the top layer of the skin is affected, and the patient feels the least amount of discomfort. Still, the skin is sore to the touch and may appear reddish in patients with lighter skin and bluish in patients with a darker complexion. The skin remains reddish or bluish even after several minutes of removing the pressure.
Treating bedsores at this stage requires removing the pressure from the area. Nursing home staff can adjust the patient’s position by using pillows and other supports. The sore may heal in a few days.
The affected area is swollen, and the skin around the sore may be red and itchy. The painful region of the skin has an open wound or a blister. Clear fluid or pus may ooze from the open wound.
Treating a stage 2 bed sore includes removing the pressure and cleaning the wound with a salt-water solution before gently drying it. A clinician may recommend pain medication several minutes before cleaning to avoid discomfort.
Cover the sore with a transparent dressing and seek medical help for any indication of infection, such as pus, redness, or fever. Expect to see signs of healing within a week.
A stage 3 pressure sore has already affected the skin’s top two layers, damaging the tissue underneath. A sunken hole called a crater appears in the affected area. The broken skin show signs of infection such as a bad odor, pus, red edges, and drainage.
These lesions have penetrated the skin's second layer and into the fat tissue. Battling the infection requires removing any dead tissue and prescription of medicine. A stage 3 sore will need extra attention, including the professional help of a physician.
A stage 4 pressure sore is the most serious. The sores have penetrated the deep tissues, and there is a significant loss of skin exposing muscle and fat tissues. In more severe cases, the sore has extended deep into the bone. There is a considerable risk of infection, and the patient requires special wound care services.
Inform the doctor as soon as possible. These wounds need immediate medical attention and most likely require surgery. It might take anywhere from three months to two years for the patient to fully heal from the injury.
Preventing Bed Sores in Nursing Homes
Pressure ulcers require the application of a well-planned patient safety strategy. Treatment of pressure ulcers among nursing home residents can be expensive and often requires antibiotics or surgery.
These precautions include regularly repositioning patients. The nursing home personnel can use support surfaces and manual patient repositioning every several hours to prevent sores. Other vital measures include preventing skin from being trapped between the patient and bed rails, using appropriate pressure-reducing devices in patients' beds, and providing proper nutrition and hydration.
Note that pressure ulcers tend to affect older patient populations. Also, a recent NCHS data brief reveals that older residents with bladder incontinence are high-risk patients for pressure ulcers.
During an individual's shift, a nurse or other qualified health care professional is also important to ensure that these preventive measures are taken.
Swift Treatment Administration
The NCHS data brief reveals pressure ulcer prevalence in nursing homes, where one in 10 residents suffer from pressure ulcers. Despite preventive measures, pressure ulcers may still develop during the resident's stay. The health consequences of bedsores require that patients be evaluated by a medical professional as part of their health care program.
The National Pressure Ulcer Advisory Panel recommends that residents who have higher pressure ulcers or stage II bedsores receive treatment from specialized physical therapists. The wound care nurses can instruct the nursing staff on essential measures and the proper techniques for dressing these wounds.
Nursing home residents are entitled to receive adequate care at a facility, including daily skin inspection for pressure ulcer prevention.
Hiring a Personal Injury Lawyer for Pressure Ulcers
When a person suffers an injury due to nursing home neglect, they can file a civil lawsuit to compensate for their elder abuse.
To win an abuse case against nursing homes, the plaintiff must prove that the defendant was negligent—the failure to apply pressure ulcer prevention measures resulted in the development of bedsores in a resident. In addition, the plaintiff must also demonstrate that they suffered damages due to the pressure injury.
If you suspect someone is a victim of nursing home neglect and elder abuse, it's vital to seek legal help and speak with an attorney at Rosenfeld Injury Lawyers. We can help you prove your case and obtain the compensation you deserve on a contingency fee basis.
An experienced personal injury lawyer will be familiar with the laws in your state and will be able to guide you through the process of filing a nursing home abuse lawsuit.
It can be difficult for family members to prove that negligent nursing home care caused pressure sores. That's why it's important to speak with an experienced personal injury lawyer who can give a free legal case review and determine the negligent party. Contact us at (888) 424-5757 for your free consultation, or use our contact form.