Pressure Ulcer Prevention
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WHAT WE DON'T KNOW ABOUT PRESSURE ULCER CARE IN NURSING HOMES--A LOT
So how come nursing homes are making such a poor job of PU care? Nationally, the prevalence of PU among nursing home residents is 14% (2) for high-risk individuals, but may range as high as 24% (3), both unacceptably high rates for a serious health problem that is often considered preventable. Not surprisingly, this costly, too common problem has fueled a rise in PU-related litigation. A report by LUMETRA (4) cites evidence that claims per occupied nursing home bed have increased at an annual rate of 14% while the average court settlement has risen to $250,000.
The incidence and prevalence of pressure ulcers in nursing homes is high enough to have sparked concern among regulators, who consider PU rates a measure of the quality of care in nursing homes. As a result, publicly reported quality measures now alert consumers to nursing homes with high PU prevalence rates.
The problem is, that for all we know about ideal PU care, we do not yet know enough about how it actually is delivered in nursing homes. Consider this analogy: Your car breaks down and won't run. Though you may not be privy to all the details, you know there exists somewhere a carefully crafted, thoroughly tested schematic that shows in elaborate detail exactly how your vehicle is supposed to operate. Even if you found that document rolled up in your back seat, however, by itself it would be useless to you. You need additional information. That is, you need to know what part or parts of your car have failed to operate properly. With that knowledge, and the schematic to guide you, you can focus on quickly fixing the problem. Moreover, you won't waste time and money fixing things that aren't broken. It's time to open the hood and climb under the chassis.
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