By Garret DeReus
Every year, thousands of nursing home residents suffer from pressure ulcers. For families navigating the complexities of long-term care, understanding pressure ulcers – their causes, prevention, and what they say about the quality of care – is crucial to protecting their loved ones.
What Are Pressure Ulcers?
Pressure ulcers, also known as bedsores or pressure injuries, are areas of damaged skin and underlying tissue that develop when prolonged pressure affects blood flow to vulnerable areas of the body. These injuries commonly occur over bony areas such as the heels, ankles, hips, and tailbone. While pressure ulcers are serious injuries, they are often preventable with proper care and attention.
Evidence-Based Prevention Protocols Exist
The National Pressure Injury Advisory Panel (NPIAP) has developed a comprehensive, standardized protocol for preventing pressure ulcers. This detailed checklist provides healthcare facilities with specific steps that should be taken to protect patients, and examples include:
- Regular risk assessments using validated tools like the Braden Scale
- Comprehensive skin assessments every shift, with special attention to areas under medical devices
- Specific protocols for moisture management and incontinence care
- Detailed requirements for patient repositioning every 2-3 hours for immobile patients
- Clear guidelines for proper nutrition and dietary consultation
- Special considerations for patients with dark skin tones, including enhanced assessment methods
Questions to Ask When Choosing a Nursing Home
When evaluating nursing homes for your loved one, consider asking whether the facility follows the NPIAP’s standardized pressure injury prevention protocols. For example, possible questions might include:
- How often do staff members assess patients for pressure injury risk?
- What type of skin assessment protocol does the facility follow?
- How frequently are immobile patients repositioned?
- What specialized equipment (such as pressure-redistributing mattresses) is available?
- How does the facility handle nutrition assessment and monitoring?
The facility’s response to these questions can be as revealing as the answers themselves. Watch carefully for signs of transparency and professionalism. Be wary if staff members appear defensive, provide vague responses, or seem irritated by your questions. Informed families are valuable partners in patient care and facilities should welcome informed inquiries.
Investigating Pressure Ulcer Cases
If your loved one has developed pressure ulcers in a nursing home setting, it’s important to investigate whether the facility followed established prevention protocols. The NPIAP checklist provides a high level framework for the standard of care that should be provided, although it is by no mean exhaustive or all that a nursing home must do to care for their patients. Families should inquire whether:
- Regular risk assessments were performed and documented
- Appropriate preventive measures were implemented based on identified risks
- Staff followed proper repositioning schedules
- Nutrition needs were properly assessed and addressed
- Skin assessments were conducted regularly and thoroughly
While families can ask these questions, investigating pressure ulcer cases often requires professional legal assistance. Medical records in these cases can span hundreds or even thousands of pages, containing complex medical terminology and documentation that requires experienced analysis. Additionally, healthcare facilities may not voluntarily provide complete information about their practices and protocols. Through legal channels such as depositions and subpoenas, experienced attorneys can access critical information about staffing levels, internal policies, and communication records that might otherwise remain hidden. These legal tools can reveal important details about how and why pressure ulcers developed, and whether they could have been prevented through proper care.
Taking Action
If your loved one has developed pressure ulcers, it’s important to understand that these injuries can develop from a deviation from established standards of care. Louisiana law provides specific protections for nursing home residents, and facilities are required to follow standards and protocols to prevent such injuries.
For guidance on protecting your loved one’s rights or to learn more about the standards of care that nursing homes must maintain, consider consulting with a legal professional who works on nursing home negligence cases.