Effective prevention and treatment measures depend on a comprehensive care plan that includes scheduled turning and body repositioning in order to stop the incidence of Bed Sores, Pressure Sores and Decubitus Ulcers says Nursing Home Abuse and Neglect Attorney Steven Peck. There is evidence that the frequency and intervals between turnings may be more critical than pressure in the production of pressure ulcers. Tthe practice of turning patients every 2 hours, and this procedure remains the mainstay of prevention strategies. Various other factors clearly contribute to the development of pressure ulcers. However, the best advice still is to establish a regimen in which pressure is completely relieved on all areas of the body at regular intervals.
Providers working with persons at risk need to be able to recognize skin changes that might indicate an impending breakdown. This is particularly true in elderly patients or in patients who are immunocompromised because the signs of impending or fulminating infection are frequently absent in these patients. Systemic signs of infection that mark the need to culture wounds include drainage, leukocytosis, fever, hypotension, increased heart rate, and changes in mental status. Prevention of progression to more serious damage requires immediate, complete elimination of pressure to the involved area.
If the proposition that pressure in excess of normal is the chief cause of pressure ulcers is accepted, then the primary prevention efforts have to be directed toward reducing or eliminating pressure over susceptible areas. The intensity and duration of external pressure and shearing forces necessary for pressure ulcers, bed sores and decubitus ulcers to occur depend on an individual's susceptibility, which could be summarized as their tissue tolerance. Nursing strategies include prevention of prolonged pressure, elimination of shearing forces and friction, and removal of skin secretions and excretions.
Statistically, 21.2% of patients who underwent surgery for more than 4 hours developed 70 pressure ulcers in the first 2 days following surgery. Twenty-one pressure ulcers, bed sores and decubitus ulcers deteriorated in the days following surgery. More than half (52.9%) of the lesions developed on the heels, and 15.7% developed in the sacral area.
Additional interventions that may be indicated for patients most at risk for pressure ulcers, bed sores and decubitus ulcers include avoiding hot water; using a mild cleansing agent that does not irritate or dry the skin; using moisturizers; using topical agents such as moisture barriers; keeping the sheets dry and wrinkle free; providing adequate intake of protein and calories; and maintaining current levels of activity, mobility, and range of motion. Massaging body prominences should also be avoided since this practice has been associated with increased tissue breakdown and risk for the formation of pressure ulcers.] Positioning devices such as pillows or foam wedges should be used to prevent direct contact between bony prominences (eg, knees, ankles). Donut-type devices should not be used because they are known to cause venous congestion and edema.
Although elderly residents are awarded certain nursing home rights, some facilities, either unknowingly or intentionally, may violate these basic rights. If you suspect your loved one is being abused in a nursing home or otherwise deprived of their nursing home resident rights, such as bed sores, dehydration, malnutrition, infection, under staffing, physical abuse, you should immediately contact us toll free at 1.866.999.9085 or on-line at www.thepecklawgroup.com for a free thorough case review and evaluation. This case review is being offered at no cost and shall help determine whether you should take legal action on behalf of your elder / dependent adult loved one. We Will Help You!!
