Pressure Ulcers

Paula Erwin-Toth's picture

By Paula Erwin-Toth MSN, RN, CWOCN, CNS

Part 4 in a series discussing the challenges and opportunities in patient/family education
For Part 1, Click Here
For Part 2, Click Here
For Part 3, Click Here

Karen Zulkowski's picture
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By Karen Zulkowski DNS, RN, CWS

Taking a positive approach when a pressure ulcer develops at your health care facility usually isn’t the first thing that comes to mind. However, it should be. When a patient develops a pressure ulcer the first thing that usually happens is the blame game: It wasn’t our fault—it must have happened at the (take your pick) nursing home, hospital, OR, ER, etc. In reality, the pressure may have happened prior to the patient’s arrival at the facility.

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Jonathan Rosenfeld's picture

By Jonathan Rosenfeld, JD

Whether the development of a bedsore, also commonly referred to as a pressure ulcer, is the fault of the nursing home or an existing medical condition, the actions taken by the health care facility after the sore is discovered can have a large impact in a lawsuit if the patient suffers from complications arising from the sore. How a nursing home treats patients with pressure sores is just as important during litigation as whether the home is responsible for the development of the sores to begin with. For this reason, nursing facilities should not implement treatment protocol that gives the impression that they are killing the patient or doing nothing to prevent the patient’s death.

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Aletha Tippett MD's picture

By Aletha Tippett MD

What steps should be taken the first time you encounter a patient with a wound? Here is my list of priorities when I assess a wound:

Jonathan Rosenfeld's picture

By Jonathan Rosenfeld, JD

Even as an injury lawyer who sometimes feels he has seen it all, I am surprised by the tricks that I have seen used by some nursing homes in order to avoid responsibility for their actions. It is unbelievable how poorly kept the patients’ charts generally are in a large number of nursing facilities to begin with, but if a facility feels that there is impending litigation in its future, they may stoop so low as to alter those records in order to cover up its actions. This type of behavior is both unethical and illegal and I am both saddened by the tactic and happy to see punitive damages awarded in cases involving such nursing homes.

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

According to the National Pressure Ulcer Advisory Panel (NPUAP, 2007), a support surface is “a specialized device for pressure redistribution designed for management of tissue loads, micro-climate, and/or other therapeutic functions (i.e. any mattresses, integrated bed system, mattress replacement, overlay, or seat cushion, or seat cushion overlay).” Because there is no method available to provide weightlessness for our patients, the next best thing we can do to prevent skin breakdown is to reduce pressure on bony prominences as much as humanly possible.

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Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 8

“…(7) Go to, let us go down, and there confound their language, that they may not understand one another's speech.(8) So the Lord scattered them abroad from thence upon the face of all the earth: and they left off to build the city. (9)Therefore is the name of it called Babel..." (Genesis, Chap. 11).

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Karen Zulkowski's picture

By Karen Zulkowski DNS, RN, CWS

As health care professionals we always want to heal our patients and make them better. This may not always be possible. We need to understand that not letting the pressure ulcer or wound we are treating get worse sometimes has to be the realistic goal.

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Karen Zulkowski's picture

Part 1 in a series discussing the process of litigation in patient care lawsuits

By Karen Zulkowski DNS, RN, CWS

Hopefully none of you will be involved in a lawsuit over patient care. However, pressure ulcers are the second most common lawsuit (wrongful death is #1) and 50% of patients with a pressure ulcer in the hospital go to a nursing home. That is 3 times the rate of any other reason for nursing home placement. To complicate matters, patients with pressure ulcers frequently go back and forth between the hospital and nursing home as additional medical complications arise and the patient’s condition deteriorates.

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