Bed Sores & Neglect

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The appearance of a bed sore can indicate that frequent and proper repositioning is not occurring for those that have been confined to a bed or wheelchair.  A bed sore can develop quickly and progress to an advanced stage in very little time.  A bed sore is often a sign of neglect when a patient is at a facility that is not able to provide the attention to changing the patient’s position frequently enough, most often in a nursing home or long-term care setting.  Due to high turnover rates, under-staffing of qualified nursing personnel, and a focus on profits over patients, many nursing homes and long term care facilities aren’t meeting the needs of their most vulnerable patients.

Most bed sores can be prevented, and those which have formed need not necessarily get worse.  Each patient’s individual circumstances must be taken into consideration by the caregiver in order to develop a plan of care which will best assure the patient will not unnecessarily suffer from a bed sore.  The following generally represent some of the precautions which health care providers should, but too often fail to undertake:

1. An appropriate and thorough and systematic assessment must be made of the patient’s risk for developing a pressure sore;
2. Appropriate periodic reassessment should be made of the patient’s risk;
3. The patient should be bathed appropriately;
4. The patient’s incontinence should be assessed and treated to assure that moisture on the skin does not contribute to the development of a pressure sore;
5. Appropriate nutrition and hydration must be maintained;
6. Repositioning of the patient should occur with a frequency to assure that the pressure is adequately relieved;
7. Use of appropriate support devices should be maintained to relieve pressure from troublesome areas;
8. Postural alignment, distribution of weight, balance and stability, and pressure relief should be considered when positioning persons in chairs or wheelchairs;
9. Appropriate lifting devices and techniques should be used to assure that shear and friction related injuries are avoided;
10. Education should be given to the patient, family, and caregivers on measures to be taken to avoid pressure sores, and appropriate documentation of such measures.

It is essential to remember that every individual is different, and has different risk factors, thus requiring a customized plan of care and diligence in carrying out the plan of care.

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