California Nursing Home Abuse Lawyers Blog

There is no accurate predictive value in pressure ulcer assessment scales. There is, in my opinion, says California Nursing Home Abuse and Neglect Lawyer Steven Peck, only one predictive factor that will determine whether at-risk patients will develop pressure ulcers: Who is caring for these patients. Like most risk assessment scales, the Braden Scale measures only the patient. It does not measure the staff. The incidence of pressure ulcers is related directly to the care, or lack thereof, given by the nursing staff.

Let us assume that there are 200 sets of identical twins with the lowest possible Braden Scale scores. One-half of the at-risk twins are admitted to an understaffed facility with poorly prepared personnel and no pressure-relieving beds. The other half are admitted to the finest facilities with well-prepared nurses, fully staffed shifts, pressure-relieving beds for each patient, and enough staff to turn each patient every 2 hours. It is my contention that the latter group will have dramatically fewer pressure ulcers than the former, despite identical Braden Scale scores.

At some time during the patient's course in the hospital or nursing home, the nursing staff fell down on the job, pure and simple should a pressure sore developed. The sicker and more at risk the patient, the harder hospital and nursing home staff must work to prevent decubitus ulcers.

It is obvious that the Hospitals and Nursing Homes are understaffed, overworked, have too many patients, too little money, and not enough specialty beds. No doubt that these are the problems and concerns. However, we need to acknowledge this and stop blaming patients because they have low Braden Scale scores. A patient develops a pressure ulcer because, at some point, he or she had inadequate pressure relief.