Pressure ulcers or sores, commonly referred to as bed sores, are a type of injury that breaks down the skin and underlying tissue. They are caused when an area of skin is placed under pressure, which can often become a problem when a person is receiving treatment in a hospital or a care home.
The NHS website quotes that an estimated just under half a million people in the UK will develop at least one pressure sore in any given year. The most at risk are those people with underlying health problems and people over 70 years old who have thinner, aged skin, particularly those with mobility problems causing them to be in a bed or a chair for protracted periods of time.
The Waterlow Score is a table used to calculate the risk of a pressure sore developing. According to the NHS NICE Guidelines on pressure sores, a risk assessment must be completed within 6 hours of admission for care treatment. Using the Waterlow Score a patient can then be nursed in view of the score by using the necessary equipment such as a foam or air mattress or alternatively through manual repositioning by the nursing staff on a regular basis.
Repositioning charts must be completed by the nursing staff and regular position changes must be noted on the patient’s records. If a patient remains on skin that presents as dusky or with redness without being moved from the same position that he or she was in when the damaged skin was first seen by the staff, then the pressure will not be lifted from that spot and a wound will develop. This is sometimes due to a lack of care and may have been avoidable had the guidelines been followed and acted upon.
Pressure sores are classified in grades between 1 and 4. What is often apparent to families and friends is redness to the skin caused by prolonged pressure in bed or in a chair without regular movement. Often the skins surface is the smallest part of the sore as the pressure develops in the body from blood vessels being restricted between the surface of the skin and the bone. A Grade 1 pressure sore usually begins on bony parts of the body such as the hip or buttocks. Grade 2 sores usually occur from a blister or a graze, often caused by poor manual handling techniques. Grade 3 sores are exposed muscle and an open wound caused by lengthy and continued pressure in one position. A Grade 4 sore is a very serious and often infected wound that will require urgent attention as the patient will often be clinically unwell due to the infection. Grade 4 pressure sores can cause death in certain cases.
Pre-emptive nursing care when a patient is at risk of developing a pressure sore is crucial. When an air mattress is noted by the nurses on admission to hospital, but never ordered or put in place, this is likely to fall below the expected standard of nursing care. If an air mattress is not available then the appropriate repositioning or turning regime must be put into place and if redness appears on the patient then the turning frequency should be increased. If care falls below the standard set out in the Nursing and Midwifery Council (NMC) Code of Conduct and the NICE Pressure Ulcer Guidelines, then a hospital or care home may have been negligent in providing adequate care and treatment. “Prevention is better than cure” is certainly the case for the treatment of potential pressure sores.
If you have concerns in relation to the topic above please call us on 0114 218 4000 and we will be happy to discuss your situation further.
0 Comments