An expert on pressure injuries, also called bedsores or pressure injuries, recommends nursing homes adopt a more individualized approach to preventing and treating the painful and sometimes deadly sores. In an opinion-editorial in McKnight’s Long-Term Care News, Jean Wendland Porter, Regional Director of Therapy Operations at Diversified Health Partners, discusses problems commonly associated with pressure ulcers and alternative approaches that will be more effective at reducing bedsores. In one example, Porter notes the common medical advice to “move a patient around every two hours” fails to take a patient’s ability to move by themselves or any aggravating factors that could make the patient more likely to develop a bedsore, such as a higher BMI or a weakened immune system. According to Porter, the “two hours” rule is not based in science at all and originates in World War II where it was deemed the most efficient method for delivering care to bedridden soldiers.
Instead of following arbitrary, “one-size-fits-all” medical recommendations, Porter likens pressure ulcer prevention measures to selecting a mattress – tailored to the patient’s comfort and healthcare plan. Porter says the best practice involves a “pressure-mapping” solution which displays any pressure points on the patient’s body. With those results, a healthcare plan is developed which includes pressure-relieving devices on areas of the body at high risk for pressure ulcers. This customized plan for each nursing home resident will need to be continually revised as mobility and healthcare needs change.
In closing the article, Porter discusses the cost-effectiveness of her approach to treating pressure ulcers. First, she notes that the softest or most expensive cushions are unnecessary and sometimes harmful to patients. In one example, a facility purchased an expensive “plastic gel-filled wheelchair cushion for every patient” to prevent bedsores. Despite the high price tag, patients describe them as a constant source of pain. Porter even describes the luxe cushions as “wildly unstable” – causing slip and fall accidents along with other injuries at the facility. After pressure-mapping the wheelchair cushions, the facility found out the device caused “red areas of pressure” in so many patients that the cushions were discarded entirely.
Continuing to discuss the cost-effectiveness of her approach, Porter notes the cost savings from improved healing times and lower legal fees. Conceding the pressure mapping approach is both labor-intensive and requires expensive technology compared to turning someone around every couple hours, Porter recommends a middle-ground that improves patient care while controlling costs or, in her words, “minimizes [the nursing home’s risk] and [the patient’s] risk with the best options available.”
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