Bed Sores
No one should ever get a bedsore.
In fact, beginning in October 2008, Medicare listed bedsores, also known as decubitus ulcers, as nothing less than “no pay” events if they’re not present upon admission to a facility.
The idea behind Medicare’s refusal to pay for bedsore treatment is this: they should never happen in the first place.
But the fact is, bedsores develop due to hospital and nursing home negligence. There’s a standard of care in the medical and nursing community as to how to prevent the development as well as properly treat them when they do develop.
When that standard of care isn’t followed, the hospital or nursing home may be held accountable in civil court for their negligence that causes any physical damage and/or pain and suffering to the patient.
In other, stronger words, if you develop bedsores or they worsen because the provider didn’t follow the accepted standard of care, YOU CAN SUE!
A bedsore in a breakdown of skin, beginning with redness and irritation and devolving down into an open crater of dead tissue that extends down to the bone.
Bedsores tend to develop over bony prominences, such as at the sacrum—just above the buttocks, as well as the elbows, heels and shoulders. Any skin that’s in constant contact with a bed sheet or wheelchair can be at risk.
Bedsores are preventable when the standard of care is adhered to.
For instance, upon admission to a hospital or nursing home the patient’s risk for development of bedsores should be assessed using a scoring system known as the Braden Scale or Norton Scale.
These scales take into consideration a global physical assessment, level of consciousness, activity level/mobility, incontinence, nutritional status and other elements. The more a person is compromised in these areas, the more likely they are to develop bedsores if the proper precautions not taken on a timely basis.
Once an assessment is done, the nursing staff, especially including the highly specialized enterostomal therapist who specializes in the identification, prevention and treatment of bedsores, should work closely with the medical staff on devising and implementing a preventative plan of care if the patient is at risk, and/or a treatment plan of care if the patient has already begun to develop the sores.
Things like using a wedge pillow to prop the patient on his or her side, turning and repositioning every two hours, keeping the head of the bed below 30 degrees to reduce sheer and friction on the lower back and buttocks and vigilantly addressing toileting issue—i.e. not letting someone sit in a dirty diaper or bed pan for more than is necessary—are but a few of the tools available to all hospital and nursing home personnel.
Unfortunately, all too often patients do not get the type of care and treatment necessary to prevent the bedsores, and once they develop, they are extremely difficult to heal away.
They are staged from I to IV, IV being the worst—essentially a hole down to the bone—and the complications from bedsores can be life threatening.
Patients who develop bedsores often must go through multiple rounds of antibiotic therapy to fight off infection.
Many times a vacuum bandage must be applied to suction out the infectious material. Sometimes a skin-flap closure surgery is necessary to close over the hole formed by the bedsore.
Bedsores can and should be avoided.
If the provider adheres to the standard of care in a timely and proper manner and isn’t negligent, there’s no reason why a patient should end up with dealing with the potentially deadly sores.