What If A Bedsore Gets Infected In A Facility

When John, a wheelchair-bound retiree, was admitted to a Georgia nursing home, his family thought he was in safe hands. Little did they know that John would develop a small, initially harmless-looking sore that would escalate into a life-threatening condition. This is a real-life scenario reflecting the serious issue of bedsores, also known as pressure ulcers, in Atlanta nursing homes. Imagine a small wound turning into a deep crater, exposing underlying tissues, muscles, and even bones, ultimately leading to severe infections and complications. This raises the question: what happens if a bedsore gets infected? The consequences can be dire, and it’s crucial to address the issue promptly to prevent further harm. If you have faced a similar issue contact an Atlanta nursing home neglect attorney for your free consultation; our attorney has won settlements as large as $225,000 for nursing home neglect cases like yours.

Bedsores Causes And Stages

Bedsores, also known as pressure ulcers, pressure sore, or decubitus ulcers, are caused by sustained pressure on the skin. They create injuries to both the skin and the underlying tissue. Pressure ulcer development mostly occurs in areas where your bones are close to your skin, such as:

• Heels
• Ankles
• Hips
• Tailbone

These wounds are particularly common in individuals with limited mobility, such as bedridden patients or those confined to wheelchairs.

The development of bedsores involves several stages:

1. Stage 1: Nonblanchable erythema of intact skin, signified by skin discoloration.
2. Stage 2: Partial thickness skin loss involving the epidermis or dermis. This can appear as an abrasion, fluid blister, or superficial wound. This may be particularly difficult to determine in dark skin individuals.
3. Stage 3: Full thickness skin loss, which may extend to, but not through, the fascia.
4. Stage 4: The most severe form, where the bedsore has progressed to the point of exposing the underlying muscles, ligaments, or even bone.

The development of bed sores is influenced by several risk factors, including:

• Extended pressure on the skin, particularly in areas of bony prominence
• Being bedridden, unconscious, or immobile
• Not being regularly turned or positioned correctly
• Not receiving adequate nutrition and skin care
• Having certain medical conditions like circulatory issues requiring diabetic care or the use of a cast

These factors can increase the risk of developing bedsores.

Neglecting bedsores can lead to serious complications. Individuals with a stage 4 bedsore are at a significantly elevated risk of infections. Alarmingly, those with Alzheimer’s or dementia may be unable to detect pain, potentially leading to a bedsore advancing to a stage 4 pressure ulcer going unnoticed. Hence, maintaining healthy skin and providing immediate medical care for vulnerable skin is key to preventing complications.

Identifying An Infected Bedsore

Early detection of an infected bedsore helps prevent further complications. Infected bedsores often present with the following warning signs:

• Fever
• Chills
• Pus
• Unpleasant odor
• Redness
• Swelling
• Increase in pain

These warning signs should not be taken lightly, as they indicate the presence of potentially dangerous infections that require proper medical care. They are also indicators of possible nursing home neglect.

Several infections are commonly associated with pressure ulcers. These include localized infections, cellulitis, and osteomyelitis. Pressure ulcers occur when the presence of such infections requires immediate medical care. Seeking medical attention is advised if any signs of infection are present, such as a fever, drainage from a sore, a sore with an unpleasant odor, changes in skin color, warmth, or swelling around a sore.

When the skin ruptures on a bedsore, the risk of infection increases. In such cases, monitoring for signs of infection and treating it with antibiotics is necessary. Extra attention should also be given to clean and dress the sore.

Complications From Infected Bedsores

The complications that can arise from infected bedsores are not just painful; they can be life-threatening. These complications can include:

• Bacterial infections
• Sepsis
• Amputation
• Renal failure
• Death

One severe complication is bacteremia, a condition where bacteria enter the bloodstream. This often manifests with indications of systemic inflammatory response, such as:

• fever
• chills
• confusion
• hypotension

The mortality rate for patients with bacteremia due to infected pressure ulcers is a staggering 50%, underscoring the seriousness of this issue.

Another severe complication is sepsis, a condition that develops when the body attempts to combat infection with an excessive response. In severe cases, sepsis can progress to septic shock, a condition in which blood pressure decreases due to an infection, potentially resulting in death due to organ failure. These complications highlight the need for early detection and treatment of infected bedsores.

Diagnosing And Treating Infected Bedsores In Georgia Nursing Homes And Hospitals

Diagnosing an infected bedsore requires a comprehensive assessment of the wound, while treatment may include antibiotics, debridement, and skin grafts. Bacteriological findings for clinically infected pressure ulcers often include multiple isolates, with bacteremia being exceedingly prevalent among patients with sepsis symptoms.

The objectives of treatment are to eliminate the infection and facilitate wound healing. Blood cultures play a significant role in the initial microbiological evaluation of all patients with a suspected infection related to pressure ulcers.

To diagnose an infected bedsore, medical professionals utilize several methods, including:

• Visual Examination: doctors observe for specific signs such as unusual changes in skin color or texture, swelling, open wounds, pus-filled blisters, redness, localized areas of nonblanchable erythema, and suspected deep tissue injury.
• Blood Tests: these can help determine if there is an infection present in the body.
• Imaging Studies: X-rays, CT scans, and MRI can be used to assess the extent of the infection and any underlying damage.

These methods are used in combination to accurately diagnose and treat infected bedsores.

Imaging studies like X-rays, CT scans, and MRI can be advantageous in the assessment of pressure ulcers. MRI has been demonstrated to possess a sensitivity of 98% and a specificity of 89% for the detection of osteomyelitis associated with pressure ulcers. CT has a relatively low sensitivity, only 11%, for diagnosing associated osteomyelitis. This is concerning to consider.

Once an infected bedsore is diagnosed, the next step is to initiate treatment. The treatment approaches focus on minimizing infection, encouraging wound healing, and treating pressure sores by alleviating pressure on the affected area through various methods and devices. To control pain, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen sodium are commonly utilized, and silver sulfadiazine (Silvadene, SSD, Thermazene) with broad-spectrum antibacterial activity is also used for treatment.

Wound debridement is a significant aspect of treating infected bedsores, a process that eliminates dead tissue from bedsores, assisting in facilitating healing and hindering further infection. There are distinct methods of debridement, including sharp debridement, which entails physically eliminating the tissue, and other non-surgical methods.

In some cases, Negative Pressure Wound Therapy (NPWT) is employed. NPWT is a highly effective method of treating pressure ulcers and promoting wound healing. It utilizes a machine that exerts controlled suction (negative pressure) on a wound dressing covering the pressure ulcer.

Skin grafts can also be efficacious in treating infected bedsores. However, they necessitate supplementary surgery to acquire the skin, which bears risks such as donor site morbidity and the risk of infection.

Prevention Strategies For Bedsores And Infections

Having understood the seriousness of bedsores and their potential complications, it becomes clear that prevention is paramount. Measures that can be taken to reduce the likelihood of bedsores include:

• Identifying those individuals who are at risk
• Enhancing overall wellbeing
• Mitigating external pressures
• Providing educational programs to caregivers regarding pressure ulcers.

To ensure proper wound healing and maintain blood flow, extrinsic risk factors like pressure, friction, shear stress, and moisture must be kept to a minimum. Implementing adequate measures to limit their negative impacts is necessary for successful outcomes. Various risk prediction scales such as the Braden and Norton scales have been developed to aid in patient assessment.

Prevention strategies that can be implemented include:

• Implementing regular repositioning
• Proper skin care
• Maintaining good nutrition and hydration
• Exercising daily

The focus should be on maintaining healthy skin, as skin breakdown is a key factor in the development of bedsores.

The Role Of Nursing Homes And Caregivers

Nursing homes and caregivers play a key role in the prevention and treatment of bedsores. They help by:

• Regularly changing the patient’s position
• Providing proper skincare
• Ensuring a nutritious diet
• Encouraging physical activity
• Ceasing smoking

Also, caregivers can undergo training to improve their knowledge, practices, and attitude towards preventing bedsores.

The presence of pressure sores in a long-term care facility can give an indication of the quality of nursing care provided. In particular, it indicates how meticulous staff are in regularly turning and positioning bedridden patients. Standard protocols for bedsore prevention in nursing homes include:

• Regular repositioning of residents
• Utilizing specialized mattresses and cushions
• Maintaining the skin clean and dry
• Furnishing adequate nutrition and hydration
• Executing regular skin assessments
• Instructing staff and caregivers

Involvement of the patients’ family and caregivers is also vital in preventing pressure injuries. Patients’ family members can be educated on the signs of bedsores and advised to report any changes to healthcare professionals promptly.

Legal Implications Of Infected Bedsores In Georgia Nursing Homes And Hospitals

Negligence or inappropriate care in the context of bedsore management in nursing homes can entail:

• Failing to regularly reposition immobile residents to relieve pressure on vulnerable areas of the body
• Inadequate hygiene practices
• Not providing proper nutrition and hydration
• Not providing appropriate medical attention and treatment for existing bedsores
• Not providing appropriate support surfaces, such as specialized mattresses or cushions, to prevent pressure ulcers.

Lawsuits linked to infected bedsores in nursing homes are common. The typical financial remuneration awarded in lawsuits concerning nursing home neglect and bedsores may vary significantly, ranging from less than $100,000 to multiple millions of dollars. Settlement amounts are contingent upon factors such as the severity of the injury and the degree of negligence. We specialize in these cases with over twenty years of experience so we can walk you through the specifics of your case.

Understanding the causes, stages, and risks of bedsores is crucial for prevention and early detection. Infected bedsores, if neglected or improperly treated, can lead to severe complications, even death. Proper care, early detection, and immediate medical attention are key in managing bedsores and preventing infections. Nursing homes and caregivers play a pivotal role in preventing bedsores through quality care, rigorous protocols, and patient education. However, when neglect or improper care leads to infected bedsores, legal implications may arise, leading to lawsuits and financial recompense for those affected.

The journey of battling bedsores can be daunting, but with adequate knowledge and timely actions, we can safeguard our loved ones in their golden years. Understanding the risks is the first step, and taking action is the next. Together, we can ensure that bedsores are no longer a hidden threat in our nursing homes, but a well-managed aspect of elderly care. Contact The Turnbull Firm for help today.