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Study Gives Suggestions for Treating and Preventing Bed Sores
By Nursing Home Law Center
Bed sores are a common affliction among residents of American nursing homes and assisted living facilities; data from the National Nursing Home Survey reports at least 8% of nursing home patients sustain bed sores and other studies have reported 11% and higher, even as high as 28%. These statistics not only help track health and wellness trends in the U.S., but also inform researchers of new potential methods of treatment and prevention.
What are Bed Sores?
Bed sores or pressure ulcers form when a stationary individual remains in one position for too long. Blood begins pooling in the lowest and boniest parts of the body, eventually creating an ulcer due to the pressure from the surrounding tissues.
These sores can worsen very quickly and leave the patient susceptible to infections and other secondary complications. These incidents typically occur more commonly at acute care facilities, but nursing home residents still face a significant risk without appropriate preventive procedures in place.
When a patient remains in bed for most of the day, the highest risk areas include the backs of the arms and legs, back, knees, toes, and heels. The vast majority of bed sores affect the lower half of the body, likely due to most bedridden patients spending their time either lying down to sleep or reclined while awake. Nursing home staff must take proper precautions to prevent at-risk patients from developing bed sores.
Preventing Bed Sores
The majority of individuals who develop bed sores are over the age of 70, so nursing home staff should automatically consider any patients over 70 as facing a higher risk of developing bed sores. Other individual risk factors can help inform staff as well, such as preexisting conditions involving blood pressure, lower extremity disability, neurological diseases from aging, nutrition, and more.
Poor blood circulation increases a nursing home patient's risk of developing bed sores. Blood collects in the lowest portions of the body because the individual's blood flow is not strong enough to push through these areas. Patients with circulatory issues require more careful attention and more frequent repositioning.
Patients who suffer from lower limb disability spend most of their time in bed and use wheelchairs when necessary. Nursing home staff must help these patients move around on a consistent basis to prevent pressure ulcers.
Some nursing home patients suffer from degenerative neurological conditions such as Alzheimer's disease and other forms of dementia that place them at a higher risk of physical injury. These patients require careful attention and care in general, and it's vital for nursing home staff to prevent these patients from injuring themselves. When a nursing home patient sustains a physical injury, he or she will take longer to recover than a younger person and will face an increased risk of bed sores while bedridden.
Lifestyle Influences on Bed Sore Risk
Aside from serious medical conditions with clear links to bed sore risk, patients can also face an increased risk of developing pressure sores from lifestyle factors like activity level, nutrition, and diet. Patients who qualify as "malnourished" on the Body-Mass Index (BMI) scale generally face a significantly higher risk of developing bed sores than patients with healthier BMI ratings. Nursing home caregivers conduct routine bloodwork and other laboratory tests for most patients, and identifying nutritional deficiencies is an important consideration in this process.
Nursing homes can help prevent bed sores by encouraging healthy, nutrient-dense food options for their patients and addressing individual deficiencies as needed. Older individuals also suffer increased healing time when they do not meet their nutritional needs. Vitamin supplementation and dietary changes can significantly reduce a nursing home patient's risk of developing bed sores, and a consistent daily activity level helps encourage healthy blood circulation and pressure.
Treating Bed Sores
Effective treatment of bed sores relies heavily on timing; any delays in addressing a positively identified bed sore can cause the wound to worsen dramatically in a fairly short amount of time. At first, a bed sore will appear as simple discoloration of the skin that gives way to surface damage that appears like a blister. Eventually, the wound opens and exposes the layers of the skin to the tissues below, leaving the patient at severe risk of infection and other complications.
Treating a bed sore is similar to treating any other open flesh wound; caregivers must ensure they keep the wound clean at all times, regularly change the patient's bandages, and track the progression of the bed sore. In some cases a patient will require debridement, or surgical removal of dead tissue at the injury site.
Once caregivers begin treating a bed sore wound, the patient's primary physician should develop a comprehensive plan to treat the injury and prevent future bed sores, accounting for the patient's individual risk factors and overall health.
The Centers for Disease Control and Prevention (CDC) report that as many as 35% of patients who develop bed sores require acute wound care services, and newer nursing home residents generally face a higher risk of developing bed sores than patients who had been residents for longer periods.
This could indicate that nursing home staff requires time to address new patients' medical issues and identify individual bed sore risk levels. Taking the time to address individual risk factors can help prevent bed sores and secondary injuries from these wounds.
- Pressure Ulcers Among Nursing Home Residents: United States, 2004
- Bedsore Statistics
- Pressure Injuries (Bedsores)