Nursing homes and other long term care facilities have become the focus of scrutiny because of increasing improper care, negligence and failure to prevent pressure ulcers. Patients are caused to suffer pain, disfigurement, decreased quality of life and increased risk of illness and death from pressure ulcers that exist due to the negligence of the healthcare provider and often lead to legal action. Pressure ulcers, or decubitus ulcers, occur when bedridden patients are left in one position for an extended period of time, preventing the patient’s weight to be shifted to avoid pressure. The area of skin that comes in contact with the bed, wheelchair or other object is caused to break down due to the constant pressure and ultimately, the tissues die because of the reduced blood flow to that area.
Pressure ulcers are categorized by severity from Stage I to Stage IV and range from a reddened area of the skin to an ulcer so severe that the muscle and bone, and often times the tendons and joints, become damaged.
Some preventive strategies involve the implementation of patient education, clincian training, strategies in developing communication and terminology materials, provision of toolkits and protocols, behavioral challenges and healthcare provider and patient adherence. Educating patients and their families about wound care and training health care providers in preventing the pressure ulcers is crucial to the prevention. Documentation should be provided to health care facilities and providers which will ensure that they become familiar with all the terms and vocabulary of pressure ulcers and prevention as well as ensure that they develop better skills in sharing information with one another. Toolkits and protocols are also important in that they provide documentation of pressure ulcer staging along with protocols for care and training materials for clincians carrying out the protocols. Behavioral challenges promise to transform acute care pressure ulcer prevention within a short period of time and healthcare provider and patient adherence and compliance will become the vehicle which drives the pressure ulcer prevention strategies.
As prevention strategies and interventions are underscored as a solution to this problem, recognition and education of the pressure ulcers remain the initial significant component of the clinical care of wound treatment.