Our frail elderly population is at risk to develop pressure sores in a nursing home environment unless certain rules and protocol are followed by the nursing home staff. Although most pressure sores can be prevented, far too many residents of nursing homes develop pressure sores which go untreated, leading to serious injury, infection and in severe cases death.
In hospitals, the incidence of pressure ulcers ranged from 2.7 percent to 29.5 percent in recent studies. Among persons in skilled care and nursing home-type facilities, prevalence of pressure ulcers was found to be 23 percent.
Certain goals must be followed in order to lessen the incidence of pressure sores:
Goal: Identify at-risk individuals needing prevention and the specific factors placing them at risk. These factors include immobility, incontinence, nutritional factors such as inadequate dietary intake and impaired nutritional status, and altered level of consciousness.
Goal: Protect against adverse effects of external mechanical forces…pressure, friction, and shear. Individuals in bed assessed to be a risk for developing pressure ulcers should be repositioned at least every 2 hours if consistent with overall patient goals. A written schedule for systematically turning and repositioning the individual should be used.
Goal: Reduce the incidence of pressure ulcers through educational programs. An educational program for prevention of pressure ulcers should include information on etiology and risk factors, risk assessment tools and their application, skin assessment, selection and/or use of support surfaces, development and implementation of an individualized program of skin care, demonstration of positioning to decrease risk of tissue breakdown, and instruction on accurate documentation of pertinent data.
Families of nursing home residents must be continually vigilant to protect their loved ones from developing pressure. At the first sign of a red spot on skin, the staff should be notified and appropriate measured taken to prevent further injury. Early intervention by an attorney skilled in nursing home cases of abuse and neglect is often the best tact for families who suspect abuse or neglect.
For more information on this subject, please refer to the section on Nursing Home and Elder Abuse.