Neglect – whether in hospital or a care home setting, pressure sores, pressure ulcers or bed ulcers should never occur.
If you or your relative go into hospital or a care/nursing home without a pressure sore/ulcer, and one (or more) develop, you may well have a claim for negligence. Read on…
Pressure ulcers don’t just develop on their own, but usually arise as a result of neglect. Poor risk assessment, poor management of the patient, or lack of staff resources – are some contributing factors.
A pressure ulcer (sometimes also referred to as a pressure, bed or skin sore) occurs when pressure or friction is being applied to an area of the skin over a period of time, due to a lack of mobility.
Poor circulation cuts off the blood supply, causing damage to the skin and the deeper layers of tissue under the skin, resulting in infection.
Sitting or lying down too long, eg being bed-ridden or confined to a wheelchair – are potential risk factors that could lead to pressure ulcers. Equally, there are some medical conditions that are known to directly impact on mobility eg heart conditions, lung conditions, diabetes, deteriorating mental health and dementia, to name just a few conditions that place people at an increased risk of developing pressure ulcers.
Failure to diagnose early on, inspect, manage, monitor and treat, can cause lengthy and painful suffering and infection, which can take a long time to heal, and can sometimes lead to major complications and even be fatal. Patients with pressure ulcers have an increased rate of mortality.
It is not just the elderly or infirm who may lack mobility, have thinner skin, or are necessarily at most at risk of developing pressure ulcers in hospital or a care home. For example, patients in hospital, who have to remain still or be less mobile whilst recuperating after major head, spine, hip or leg surgery, or who are under heavy sedation (or induced coma) – are also at highest risk of developing pressure ulcers.
Measuring the risk of pressure ulcers is done using the Waterlow scale – a simple scoring system in the form of a chart used by healthcare professionals to assess risk of developing pressure ulcers. The higher the score, the greater the risk.
Therefore regular risk assessments should be carried out to review the patient’s skin condition and integrity, as a lack of movement and mobility can cause pressure ulcers.
Patients who may be vulnerable should be turned or repositioned regularly to minimise the risk of developing a pressure ulcer.
Diligent and regular risk assessments and inspection should identify any pressure ulcer developing. Applying immediate and effective treatment and care should successfully resolve the problem if spotted early on, and before it develops into something more problematical, sinister and difficult to treat.
Left untreated, some pressure ulcers can go on to can cause deep infection in the wound, which can spread quickly and lead to serious and severe complications.
Pressure ulcers are graded in order of severity:
Grade 1 is at the bottom end of the scale and is the least severe. The grades increase in severity, through to Grade 2, and with Grades 3 and 4 usually being the cause of litigation against the NHS or care homes for negligence. A Grade 1 pressure ulcer is the easiest to treat and has the quickest recovery time; whereas conversely, Grade 4 is the most severe, and takes the longest time to heal, if in fact it can be healed at all. Sometimes, infection is so bad, that intervention by surgery is needed to deal with the condition which may include amputation.
Early diagnosis, treatment and good care management are the keys to success.
In a hospital setting all pressure ulcers Grade 2 and above should be reported on admission.
For more information about pressure ulcers, pressure sores and bed sores, read [link to Farley Dwek website page].
You may be entitled to compensation if you have sustained a pressure ulcer that could have been avoided with proper care. Why not call us on 0800 011 4136 or 0161 272 5222 or firstname.lastname@example.org for a FREE consultation.
Posted In: Clinical Negligence