How Bedsores Can Be Prevented

Time and attention are the basic ingredients for preventing bedsores. Both are becoming scarcer with the ever-dwindling number of nurses in the workforce. When a person is bedridden, the main thing to do for prevention is to reposition the patient from side to back to the other side every two hours. There are no exceptions, and there should be zero tolerance for failure. The hospital must supply forms for the nurses to document the length of time that the client spends in each position. There are varieties of designs, but I shall give you one for illustration here.

Turning and Positioning Record

Date: 11/20/02

Shift: 7-3

Position Left Lateral Supine Right Lateral Supine

Start Time

07:00

09:00

11:00

13:00

End Time

09:00

11:00

13:00

15:00

Length of Time

2 hrs.

2 hrs.

2 hrs.

2 hrs.

Date: 11/20/02

Shift: 3-11

Position Left Lateral Supine Right Lateral Supine

Start Time

15:00

17:00

19:00

21:00

End Time

17:00

19:00

21:00

23:00

Length of Time

2 hrs.

2 hrs.

2 hrs.

2 hrs.

Date: 11/20-21/02

Shift: 11-7

Position Left Lateral Supine Right Lateral Supine

Start Time

23:00

01:00

03:00

05:00

End Time

01:00

03:00

05:00

07:00

Length of Time

2 hrs.

2 hrs.

2 hrs.

2 hrs.

The hospital should supply the following devices to protect the skin of a person at risk: foam rubber heel pads, sheepskin bed pads, an air or water mattress, an air-flotation bed, a drawsheet, and Chux. If the hospital has not supplied any of these, ask for them. Keep at it until everything has been supplied. Don't take "no" for an answer and don't assume "yes" means it will happen. Follow up to be sure.

The idea behind all of these devices is to relieve pressure by redistributing it. If there is compression of any single body part for too long, the skin will break down and an ulcer will develop. There are no exceptions. There is a simple care plan that should be in place in every hospital for every patient who is at any level of risk of developing pressure ulcers.

The care plan on the facing page is what you should be looking for. Accept nothing less. Let the executives know that any skin breakdown would be a disgrace and that you will take legal action if there is any breach of duty. There is no valid excuse for not following every aspect of this prevention protocol. Any hospital executive who claims this is too much to expect because of the nursing shortage is guilty of false advertising when the hospital is held out to be a facility that delivers quality care in accordance with accepted standards, because the standard is zero tolerance for bedsores!