This case involves a woman who developed pressure sores following a surgical procedure. The patient was admitted to an inpatient rehabilitation facility and was not found to have any pressure wounds at the time of admission. The patient was primarily sedentary during her time in the facility, however, the records indicate that the patient was not routinely assessed for pressure wounds. After 3 weeks, the patient was discovered to have an advanced stage pressure sore on her tailbone. The patient was transported back to the hospital and was diagnosed with sepsis and an infected pressure sore with foul-smelling drainage. The patient developed an infection in her bone secondary to the pressure sore. She required surgical intervention and debridement to treat the wound. An expert in wound care was sought to review the records and opine on the standard of care for prevention of pressure sores.
Question(s) For Expert Witness
- 1. Please describe your background in wound care.
- 2. What measures can be taken to prevent decubitus ulcers in rehabilitation patients?
Expert Witness Response E-125535
I am a certified registered nurse and a nurse practitioner specializing in wound, ostomy, and continence care. I am also the director of clinical operations at a large university medical center in the mid-Atlantic. I have worked with wounds and skin issues since 1993, both lecturing and publishing on the topic at the local, regional and national level. Getting people moving is essential to prevent pressure injuries. Assisting in position changes, encouraging position changes, and educating individuals on the importance of position change are all part of the standard of care. We are finding out that pressor use in the ICU setting is having an impact on the formation of pressure injury following cardiac surgery and other serious illnesses. Many pressure injuries initiate before they occur. In addition to prevention strategies, identifying initial issues and prompt intervention can prevent worsening.