Assessing bedsores: A Critical Step in Effective Management

Introduction

Bedsores, also called bedsores, decubitus ulcers, or pressure ulcers, are a concern in healthcare settings, particularly for those whose mobility is limited. Health care providers like nursing homes may be subject to civil liability through a lawsuit for bedsore injuries. Bedsores can also become infected, causing sepsis and even wrongful death.

The existence of a bedsore is often an indication that a health care facility like a nursing home was negligent, but a careful review of the medical records is important in order to make this decision.

Assessing bedsores is a critical step in the treatment and healing of bedsores. In this article, we will explore the importance of assessing bedsores, assessment key factors, and how healthcare professionals like nurses in nursing homes can ensure proper evaluations.

The Importance of Assessing Bedsores

Bedsores can develop rapidly and progress through various stages (generally Stage 1 through Stage 4), each requiring specific types of treatment. A proper assessment of these injuries is crucial. 

Nursing home wound nurses must determine the bedsore’s severity. This informs treatment decisions. Bedsores are categorized into stages ranging from Stage 1 (superficial) to Stage 4, and accurate staging guides appropriate care. Assessments provide essential information for developing a tailored treatment plan. Different bedsores may require varying approaches, such as wound dressings, offloading techniques, or surgery.

Regular assessments allow healthcare professionals in nursing homes and other facilities to monitor the healing progress of bedsores. Adjustments to the treatment plan can and should be made based on improvements or setbacks. Identifying and assessing bedsores early can help prevent complications like infection, cellulitis, or even sepsis (and sepsis, which is essentially a blood infection) can lead to septic shock, organ failure, and death).

Key Factors in Assessing Bedsores

Location: The location of the bedsore is crucial. Some areas, like bony prominences (heels, sacrum, elbows), are more prone to bedsores. Documenting the exact location helps in tracking changes and providing appropriate interventions.

Size: Measuring the size of the bedsore is essential. This is typically done in centimeters (length x width x depth). Consistent measurements over time help assess progress in healing or worsening.

Depth: aside from the measurement of the depth, bedsores can range from superficial to deep tissue damage down into the muscle, sometimes even down to the bone.. Determining the depth is vital for staging the injury and selecting the appropriate treatment.

Stage: Bedsores are categorized generally as a Stage 1, Stage 2, Stage 3 or Stage 4. There is also a separate category for “Deep Tissue Injury” or DTI. Each stage/classification has specific characteristics, and recognizing these helps in accurate staging and treatment.

Tissue Type: Assess the type of tissue present within the wound. Is it granulation tissue, slough, eschar, or necrotic tissue? This information guides debridement decisions and wound care.

Exudate: Assess the amount and type of wound exudate (fluid). Some bedsores may have excessive drainage, which can affect healing and require specialized dressings.

Surrounding Skin: Examine the condition of the skin around the wound. Look for signs of maceration, erythema (redness), or infection. Healthy surrounding skin is essential for healing.

Pain Assessment: Evaluate the patient’s pain related to the bedsore. Pain management is a crucial aspect of bedsore care.

Infection: Assess for signs of infection, such as increased pain, redness, warmth, or foul odor. Prompt treatment is essential to prevent complications.

Underlying Factors: Consider the patient’s overall health, comorbidities (e.g., diabetes, vascular disease), nutritional status, and mobility level. These factors influence the risk of developing and healing bedsores.

Ensuring Thorough and Accurate Assessments

To ensure thorough and accurate assessments of bedsores, healthcare professionals in nursing homes and other facilities should:

Standardize Assessment Procedures: Establish standardized protocols for bedsore assessment within healthcare facilities to maintain consistency and reliability.

Regularly Reassess: Regular reassessment is necessary to track progress or deterioration accurately.

Involve a Multidisciplinary Team: Collaborate with wound care specialists, nurses, physical therapists, and dietitians to provide comprehensive care tailored to the patient’s specific needs.

Educate Caregivers: Nursing homes and other health care facilities should train caregivers on how to assess bedsores and recognize warning signs of complications like infection and sepsis. Their involvement can aid in early detection and prevention.

Document Thoroughly: Maintain detailed records of bedsore assessments, including photographs when appropriate. Clear documentation aids in communication and decision-making. Lack of documentation makes it impossible to track wound progress, which is critical for treatment decisions.

Conclusion

Assessing bedsores fundamental aspect to their management and prevention. It allows healthcare professionals to determine the severity, plan appropriate treatments, monitor progress, and prevent complications. By following standardized assessment procedures, involving a multidisciplinary team, and educating caregivers, healthcare providers like nursing homes can ensure thorough and accurate evaluations, ultimately improving the outcomes and quality of life for individuals at risk of bedsores. Early assessment and intervention are key to effectively managing and preventing these challenging wounds. To avoid being sued for bedsore injuries or wrongful death, nursing homes and other health care providers should ensure their nurses and nursing staff are well-trained. Contact Pleasant Law, PLLC for a free nursing home or elder abuse case evaluation if you or someone you love has been injured by a bedsore.