Among the key points of the study:

- 95 percent of pressure ulcers occur in the lower part of the body.

- The incidence of pressure ulcers is actually higher in acute care hospitals than in nursing homes.

- A great majority – 70 percent – of all pressure ulcers occur in people 70 years of age or older

- The use of catheters in incontinent patients greatly increases the risk of bed sores

- Healing occurs most rapidly when open bed sores are closed surgically

The study recommended that care staff turn patients every 1 1/2 hours, versus the usually standard two hour interval. Researchers also found that doctors should take great care in selecting preventative devices, which range pressure-relieving mattresses to manual movement from nurses and doctors. Proper preventative devices should ward off all bed sores, which vary in severity from stage 1 to stage 4.

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Armed with a basic understanding of the mechanics behind the development of bed sores, medical professionals suggest alleviating the pressure on the body on regular intervals.

If a patient is mobile, they should be encouraged to get active on a regular basis. Obviously, for physically incapacitated patients who are unable to move on their own, staff assistance is necessary to relieve pressure.

After all, it’s not like bed sores develop due to a medical complication or error.  Rather, bedsores (or interchangeably used with the terms: pressure sores, pressure ulcers or decubitus ulcers) are almost always indicative of a facility that has grossly neglected their patients by failing to tend to basic needs like regularly moving the patient or keeping them clean and dry.

A new study conducted by the University of Cincinnati College of Nursing (Ohio) is looking to see if the implementation of a reminder-system for the staff to move and re-position patients on a regular basis can help in the reducing the number of patients who acquire pressure sores during their admission.

Under the year-long pilot program, music plays for one or two minutes every two-hours for a 12-hour period. All staff at the facilities– from maintenance workers to administrators get involved to assist in moving immobile patient s or remind relatively able-bodied patients to get up and move around.

Through the course of the pilot program, none of the patients at the facilities involved have developed bedsores.

When I read stories such as this, I am reminded how a little effort on the part of nursing homes can go a long way towards preventing this painful and potentially life-threatening medical condition.

Related:

Music could help prevent bedsores, By Cindy Kranz January 5, 2011

What steps can be taken to minimize the risk of developing bed sores?

What is ‘turning’ and why is it important to prevention of bed sores?

Why are physically disabled patients at risk for developing bed sores?

What areas of the body are prone to develop bed sores?

Bed Sore FAQ: Prevention

When pressure goes unrelieved for extended periods of time, tissue dies and a wound develops in the area.

Armed with a basic understanding of the mechanics behind the development of bed sores, medical professionals suggest alleviating the pressure on the body on regular intervals.

Related:

Why is ‘turning’ so important to prevention of bed sores?

What steps can be taken to minimize the risk of developing bed sores?

Who Said Nursing Care Was Easy? The Prevention Of Bed Sores Requires Staff To Turn & Reposition Patients On A Reqular Basis

Hospital administrators should take note of the program implemented by Texas Arlington Memorial Hospital to reduce hospital-acquired bed sores.  The program implemented by Texas Arlington resulted in a 63% reduction in pressure sores.  This hospital accomplished this by taking the following steps:

• Identifying decubitus ulcers on all new admissions
• Reducing use of diapers amongst patients
• Encouraging all staff to look for and document decubitus ulcers, even in their earliest stages
• Paying extra attention to patients who are bed bound or who’s skin comes into contact with medical equipment like oxygen masks or tubing
• Implementing daily skin checks and intensive, hospital-wide skin checks on a quarterly basis to help the facility keep accurate tabs on how well its wound prevention program is working
• Empowering all staff to bring the early signs of bed sores to the attention of physicians and supervisors

Reduction of Hospital-acquired Pressure Ulcers at Texas Health Arlington Memorial Hospital

Nursing Homes Abuse Blog: Hospital Bed Sores

Turning should be completed at intervals set forth by a physician.  However, turning of patients at least every two hours is usually considered to be the minimally accepted interval.  In bed-bound residents, the staff should rotate the patient to their sides.  In residents who spend most of their time in wheelchairs, staff need to lift the residents out of their chairs.

Despite its prevalence, incontinence is often treatable.  Any resident who has been deemed incontinent should be evaluated by a physician to determine if the cause of the incontinence is physical or psychological.  Once the cause is identified a combination of behavior modification and staff assistance may be of some help.  In other cases, medication or surgery may also help alleviate the incontinence issues.  Diapers or similar undergarments should only be used as a last resort.

Incontinent patients have an increased vulnerability for developing bed sores (also called: pressure ulcers, pressure, sores or decubitus ulcers) because when urine or fecal material is held against the skin, the damp, acidic nature of the wastes cause the skin to become weakened and susceptible to cracking and peeling–literally eroding the bodies natural defenses.

Proper maintenance of the skin, requires the skin to be kept dray and sanitized.  To minimize development of pressure sores, facilities should take the following precautions for incontinent residents:

• Have adequate staffing levels: encourage patients, who are able, to use the toilet and those who are unable to notify staff as soon as a change of sheets or clothing is required
• Clean patients regularly with mild soap and lukewarm water
• Moisturized patients daily, the lotions help create a barrier on the skin
• Use proper turning techniques to minimize time spent in one location
• Keep the bed elevation (in other words, keep the head even as possible with the rest of the body)- this reduces pressure on the sacrum

Related Article:

Incontinence Amongst The Nursing Home Population, Nursing Homes Abuse Blog

• Skin should be inspected for discoloration
• Skin and tissue should be examined for any temperature change (warm / cold)
• The consistency of the skin should be assessed to see if the area has become firm or softened

Each person’s tissue tolerance is different.  In order to provide the most effective bed sore prevention measures, staff should figure in the tissue tolerance when composing an individuals care plan / turning intervals.

Turning is especially important in patients who are in a sitting position (the head above 30 degrees) because all of their weight gets pressed into the buttock area.  Consequently, many patients who are confined to wheelchairs should be moved into a bed (with their head even level with their body) to help alleviate pressure build up.

Many situations where a resident develops a bed sore at a hospital or skilled nursing facility, stem from the fact that the staff failed to properly turn the person.

F-Tag 314 (codified as 42 C.F.R. 483.25(c)), relates to bed sores (also referred to as: pressure sores, pressure ulcers or decubitus ulcers):

Based on the comprehensive assessment of a resident, the facility must ensure that:

(1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable; and

(2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing.