Pressure Ulcers

There are strict Federal and State regulations prescribing what steps a nursing home and its staff must take to prevent and heal pressure ulcers.  The regulations specify that no resident who enters a facility without pressure ulcers should develop pressure ulcers while at the facility unless it is “unavoidable.”  It is never unavoidable unless the ulcer develops despite adequate assessment, planning, implementation and monitoring of the resident’s condition.  Some residents may be more susceptible to pressure ulcers due to decreased mobility, diabetes or vascular disease, but even in those cases, pressure ulcers are usually avoidable with proper care and treatment.  Pressure ulcers range from Stage I ulcers, which are characterized by reddish skin following prolonged pressure, to Stage IV ulcers characterized by open sores which run through the skin and down into the tissue or bone beneath.  Pressure ulcers can become infected, leading to sepsis and death.  The bottom line is that in most cases, nursing homes should be able to prevent the development or worsening of pressure ulcers, and the regulations require that.  Ulcers occur because staff leave residents lying in one position or in urine or fecal matter too long.  This happens because some nursing homes are chronically understaffed, and CNAs simply do not have sufficient time to reposition residents frequently enough to prevent bed sores.  In addition, residents may be malnourished or dehydrated, thereby lacking the protein, caloric and water intake necessary to heal their skin.  Residents and their loved ones must be vigilant to make sure that nursing home staff are taking the necessary steps – the steps mandated by law – to protect against pressure ulcers.