Bedsore Injury

Written By: Kenneth LaBore | Published On: 3rd February 2017
Nursing Home Bedsore Injury is Preventable

Nursing Home Bedsore Injury is Preventable

Bedsore Injury Injuries Are Preventable

Bedsore injury is preventable with proper care and treatment and sufficient staff at nursing homes and other elder care facilities to ensure that residents who need assistance are turned and repositioned at least every two hours to assure that they do not have long periods of time without pressure relief.  There are several points of the body that are more prone to bed sore pressure ulcers, including the back of the head, shoulder, buttocks, coccyx, and back of heels.

Bedsore Injury Stages

According to the Mayo Clinic, bedsores fall into one of four stages based on their severity. The National Pressure Ulcer Advisory Panel, a professional organization that promotes the prevention and treatment of pressure ulcers, defines each stage as follows:

Stage 1

The beginning stage of a pressure sore has the following characteristics:

  • The skin is not broken.
  • The skin appears red on people with lighter skin color, and the skin doesn’t briefly lighten (blanch) when touched.
  • On people with darker skin, the skin may show discoloration, and it doesn’t blanch when touched.
    The site may be tender, painful, firm, soft, warm or cool compared with the surrounding skin.

Stage 2

At stage 2:

  • The outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) is damaged or lost.
  • The wound may be shallow and pinkish or red.
  • The wound may look like a fluid-filled blister or a ruptured blister.

Stage 3

At stage 3, the ulcer is a deep wound:

  • The loss of skin usually exposes some fat.
  • The ulcer looks crater-like.
  • The bottom of the wound may have some yellowish dead tissue.
  • The damage may extend beyond the primary wound below layers of healthy skin.

Stage IV

A stage IV ulcer shows large-scale loss of tissue:

  • The wound may expose muscle, bone or tendons.
  • The bottom of the wound likely contains dead tissue that’s yellowish or dark and crusty.
  • The damage often extends beyond the primary wound below layers of healthy skin.

Unstageable

A pressure ulcer is considered unstageable if its surface is covered with yellow, brown, black or dead tissue. It’s not possible to see how deep the wound is.

Deep tissue injury

A deep tissue injury may have the following characteristics:

  • The skin is purple or maroon but the skin is not broken.
  • A blood-filled blister is present.
  • The area is painful, firm or mushy.
  • The area is warm or cool compared with the surrounding skin.
  • In people with darker skin, a shiny patch or a change in skin tone may develop.

Bedsore Injury Skin Care

Residents must receive necessary skin care to help prevent pressure  and bedsore injury.  According to Minnesota Administrative Rule 4658.0520, Subpart (2)(B), clean skin and freedom from offensive odors. A bathing plan must be part of each resident’s plan of care. A resident whose condition requires that the resident remain in bed must be given a complete bath at least every other day and more often as indicated. An incontinent resident must be checked at least every two hours, and must receive perineal care following each episode of incontinence. Clean linens or clothing must be provided promptly each time the bed or clothing is soiled. Perineal care includes the washing and drying of the perineal area. Pads or diapers must be used to keep the bed dry and for the resident’s comfort. Special attention must be given to the skin to prevent irritation. Rubber, plastic, or other types of protectors must be kept clean, be completely covered, and not come in direct contact with the resident. Soiled linen and clothing must be removed immediately from resident areas to prevent odors.

Bedsore Injury Must Be Reported

According to Minnesota Statute 144.7065, each facility shall report to the commissioner the occurrence of any of the adverse health care events described in subdivisions 2 to 7 as soon as is reasonably and practically possible, but no later than 15 working days after discovery of the event. The report shall be filed in a format specified by the commissioner and shall identify the facility but shall not include any identifying information for any of the health care professionals, facility employees, or patients involved. The commissioner may consult with experts and organizations familiar with patient safety when developing the format for reporting and in further defining events in order to be consistent with industry standards.

The statute requires the reporting to the Commissioner of the Department of Health, stage 3 or 4 or unstageable ulcers acquired after admission to a facility, excluding progression from stage 2 to stage 3 if stage 2 was recognized upon admission.

Additional Information on Bedsore Injury

Also see some of my other blogs on this topic:

Bedsore Stages

Pressure Injury Stages

Pressure Sore Injury

Pressure Injuries

Bedsore Injury Neglect Attorney

If you have questions about nursing home abuse and neglect contact Kenneth LaBore for a free consultation.  There is no fee unless there is a verdict or settlement offer from the wrongdoer.  Mr. LaBore can be reached directly at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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