Pressure Ulcers
Medical negligence compensation claims involving the development of pressure ulcers (also known as pressure sores or bedsores) are common.
How do pressure ulcers develop?
They occur as a direct result of unrelieved pressure and distortion of body tissues (skin). The most vulnerable areas are over bony prominences such as the sacrum (base of the spine), buttocks, hips, heels, ankles, elbows, ears and the back of the head. When the skin’s tissues are not relieved of pressure, waste products build up and this can lead to tissue necrosis (the death of cells), clinical infection and even death from septicaemia.
How can and should pressure ulcers be prevented?
The simple answer is through good nursing care. Every patient in hospitals, nursing homes and care homes should undergo an assessment. The most commonly used is the Waterlow Scale, which assesses several factors in order to decide whether a patient is at high risk of developing pressure sores. Guidance has also been provided by NICE (National Institute for Clinical Excellence) by way of the “Pressure ulcer risk assessment and prevention” guide.
Factors which should be taken into account when assessing patients are reduced mobility, sensitivity to pain or discomfort, poor circulation, moist skin, previous history of pressure ulcers, age and inadequate diet or fluid intake.
Nursing care should include the alleviation and redistribution of pressure, either by safe repositioning, or by the provision of appropriate support surfaces or pressure relieving devices. By risk assessing patients and then implementing appropriate care plans, the risk of pressure ulcers developing is reduced and avoided. However, sometimes (despite a high level of nursing care) some patients will still develop pressure ulcers, usually due to an underlying medical condition, such as irreversible tissue hypoxia (where the tissue is deprived of adequate oxygen).
Consequences of pressure ulcers
Pressure ulcers can be very painful and difficult to heal, as the wound has to heal from the inside out. Infection is another risk and the development of septicaemia is not uncommon.
Extensive plastic surgery may be required and this can result in a prolonged and costly hospital stay, with a long period of recovery and patients can be left with unsightly scarring.
In today’s climate, with an overstretched NHS and understaffed nursing homes and care homes, more and more patients are developing and suffering from pressure ulcers that could and should be prevented.
If you or a relative has suffered pressure ulcers (or pressure sores), as a result of neglect in a hospital, nursing home or care home, you could be entitled to claim compensation for medical negligence.
Things to consider in pressure ulcer compensation claims are:
- Was a proper skin assessment performed regarding the risk of developing bedsores?
- If in hospital, did this assessment occur within 6 hours of hospital admission?
- Was the assessment, usually the Waterlow score as recommended by NICE, documented in the patient's notes and an appropriate care plan implemented?
- Did the patient receive adequate assistance in moving every 2-4 hours?
- Where they were turned or moved by nursing staff, were all position changes documented?
- Were appropriate and adequate pressure relieving mattresses or cushions, as recommended by the NICE guidelines, made available and used?
- Did the patient receive proper, nutritional support and were they given assistance to eat if required?
- If the patient was admitted into a hospital or care home with pre-existing pressure ulcers, these should be noted and dressings removed to assess the extent of the wound and redressed appropriately. Care should be taken to prevent these sores from becoming infected and further deterioration.
