An area of skin breakdown that occurs when sustained pressure cuts off blood circulation — usually in patients confined to their beds in hospitals and nursing homes — a bedsore (pressure sore, pressure ulcer, decubitus ulcer) can result in a wound so deep and painful that some patients require narcotics. If a bedsore becomes infected, the complications can be fatal.
“They are not just little sores,” said a senior scientist at the Institute for Clinical Outcomes Research in Salt Lake City. “If you’ve ever seen a very bad one, frankly, it would make you sick. You see a very reddened outer area, then you see, depending on how deep it is, just this hole in the skin, and it goes right down to the bone.”
Experts estimate that two million Americans suffer from pressure ulcers each year, usually through some combination of immobility, poor nutrition, dehydration, and incontinence. The Centers for Disease Control and Prevention does not keep statistics on fatalities, but one prominent victim was the actor Christopher Reeve, who died of a bedsore infection in 2004 in the middle of a heroic battle against paralysis.
New research is suggesting that the battle against bedsores requires a team approach, enlisting everyone from nurses and nursing assistants to laundry workers, nutritionists, maintenance workers and even in-house beauticians.
In a study of a collaborative program involving 52 nursing homes around the country, The Journal of the American Geriatrics Society reported last August that team efforts had reduced the number of severe pressure ulcers acquired in-house by 69 percent.
“Preventing pressure ulcers is a 24/7/365 kind of job,” said a clinical reviewer at Qualis Health in Seattle, who helped to set up the collaborative in 2003. “It’s not as if one person can get it all done. And if it fails just a little bit, just during the weekends, for instance, you’re not going to get the results. It takes tremendous consistency.”
At a nursing home in Indiana, for instance, “the laundry workers helped us see that some clothes weren’t fitting the residents properly and were restricting their skin,” said a registered nurse there.
The kitchen staff began putting protein powders in cookies to boost nutrition. They added buffet dining, so residents would not remain in one position for so long, compressing fragile skin.
Even the beauty shop “realized that wait times needed to decrease,” the nurse said, and residents should be repositioned while getting their hair done. “It was all departments looking at everything, and it was just amazing the information that flowed through.” For more, read the story.
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.
Posted on Sat, May 23, 2009
by Robert Carter