Top 3 steps you can take to avoid pressure sores in a nursing home or hospital in Kingston, New York

Pressure sores are known by several different names including bedsores, pressure ulcers and decubitus ulcers. They are mean the same thing: ugly, open wounds that usually develop on parts of the body that have bony prominences, such as the spine, coccyx or tailbone, hips, heels, and elbows to name a few.  When you are immobile and cannot get up out of bed, these parts of the body  are most susceptible to pressure sores due to the pressure of the bony prominences against your skin.  Unrelieved pressure by the bony prominences for more than two hours can lead to the development of a pressure sore.

The usual mechanism of forming a pressure sore is from pressure.  Any area of tissue that lies just above a bone is very likely to form a pressure sore.  The weight of the person's body presses on the bone, the bone presses on the skin and tissue that cover it, and the tissue is trapped between the bone structure and the bed or wheelchair surface.  This situation compresses the blood vessels in the skin and underlying tissues.  This is the basic mechanism for the formation of pressure ulcers. 

When pressure sores develop in a nursing home or hospital, they are often difficult to treat  For patients with compromised blood circulation, i.e., diabetic patients, the pressure sores can be next to impossible to heal.  The patient is left with an open, ugly wound that won't go away.  So, what can you do?  Prevent pressure sores before they develop.

Step #1 for preventing pressure sores: turning and positioning the patient every two hours

The common areas for the formation of pressure ulcers and their prevention is a basic area covered in all nursing schools by all licensed nursing programs (LPN or RN).  Prevention consists of changing the patient's position every two hours or more often if needed. The two-hour timeframe is a generally accepted maximum interval that tissue can tolerate pressure without damage.

Turning and positioning is common knowledge for physicians, licensed nurses, physical therapists and nursing assistants, but it is often overlooked.  Even on flotation mattress beds, turning and positioning is requred for patients at risk for pressure sores.

Step #2 for preventing pressure sores: skin inspections and personal hygiene

The second step for preventing pressure sores is keeping the high risk parts of the body clean and performing skin inspections on a daily basis.  Nurses often neglect to inspect a patient's skin on daily basis and that can lead to the development and progression of pressure sores. Good personal hygiene is the key to preventing pressure sores.

All pressure sores have a course of injury similar to a burn wound.  The pressure ulcer begins as a mild redness of the skin and/or blistering such as a first degree burn.  If the area of redness and inflammation is left untreated, the blister develops into a deep open wound with a lot of blackened tissue in it such as a third or fourth degree burn.  The black tissue is called an eschar.  A pressure ulcer can develop in as little as eight hours in an immobile, debilitated person.

The key to the prevention of pressure sores is detecting the sore in its earliest stage when there is only redness and inflammation.  When treated in stage 1 or stage 2, pressure sores are much easier to treat and usually heal within 2-3 days. 

You must insist that the nurses document their skin inspections during each nursing shift; there are usually three nursing shifts during a day.  You should ask to see the nurses' progress notes and their documentation of their skin inspections.  The skin inspections should be performed on each of the high risk parts of the body, such as the spine, coccyx or tailbone, hips, heels, and elbows.

Step #3 for preventing pressure sores: padding and specialty beds/mattresses

Prevention also consists of protection and padding to prevent tissue abrasion as well as the elements of nutrition, hydration and hygiene.  Special floatation beds can be ordered by your physician to remove all pressure from the involved area(s) to prevent further decay of tissue and promote healing.  When you have redness or inflammation in a part of your body that is most susceptible to pressure sores, your doctor can order a specialty mattress to relieve pressure and apply padding to prevent friction.

Be a proactive advocate for your family member

If your loved one is immobile and unable to turn and position in bed, she is at significant risk for pressure sores.  You must be an advocate for you loved one in a nursing home or hospital--if you don't, who will?.  Follow the instructions in this article to make sure the nursing staff takes the interventions to prevent pressure sores.

If you have any questions or want more information, I welcome your phone call on my toll-free cell at 866-889-6882 and you can always request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website, www.protectingpatientrights.  Thank you for taking the time to read this article.