By Nursing Home Law Center
In the past, pressure ulcers were primarily associated with poor nursing home care. Times have changed. Today, pressure ulcers acquired during a hospitalization are a growing problem. In our medical negligence group, we continue to see clients who enter a hospital for acute care, only to wind up with an acquisition of a pressure ulcer during their hospitalization.
Hospitals, like nursing homes, should conduct an assessment of all new patients and determine who may be at risk for developing pressure sores and implement prevention techniques. In the case of patients who may be in a hospital for an extended period, facilities should perform ongoing monitoring of skin integrity and change care as needed.
Unlike nursing homes or assisted living facilities that tend to care for patients over extended periods of time, hospital-care tends to be for shorter duration and focused more on the providing medical treatment as opposed to more generalized care.
Perhaps the hospital-based focus on providing acute care is the core reason why pressure ulcers acquired during a hospitalization have been increasing recently. A study sponsored by the Agency for Healthcare Research and Quality (AHRQ), revealed the number of hospital patients who develop pressure ulcers during their hospitalization (also known as pressure sores, bed sores or decubitus ulcers) has increased by 63% since 1996.
The AHRQ study further calculated that the hospital stay for treatment of pressure ulcers was 13 days and cost $37,500.
While a number of factors may increase the likelihood that patients may develop pressure ulcers, the underlying mechanics of pressure ulcers is premised on the scenario of unrelieved pressure on areas of the body for extended periods. When pressure goes unrelieved on the body, blood circulation to the area is reduced and the tissue in the area dies.
Elderly hospital patients are particularly susceptible to development of pressure ulcers because we tend to lose muscle mass as we age. Similarly, older hospital patients tend to have limited mobility– increasing the chances they stay in one position for longer periods of time.
Although pressure ulcers can develop in any area of the body– including unlikely areas like the back of the head, ears and fingers; the majority of pressure ulcers develop over bony prominences of the body such as: buttocks, heels, ankles and back.
With attentive staff, the overwhelming number of hospital-based pressure ulcers are preventable. Acknowledging that pressure ulcers are a real and potentially life threatening problem is the first step that hospitals need to take in order to reduce the incidence of pressure ulcers at their facilities. Additionally, implementing well-accepted preventative techniques is critical.
Widely accepted pressure ulcer prevention includes:
In order to determine if the negligence a hospital is responsible for the development of a pressure ulcer, it is important to gather all hospital records and take photos of the wounds. In our medical negligence practice, we commonly see that poor communication amongst staff is a major culprit for hospital-acquired pressure ulcers. The poor communication is frequently found in medical charts where physician orders are not documented and patient condition goes undocumented for extended periods.
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