IDPH has cited and fined The Village At Victory Lakes when the facility failed to periodically remove and check for pressure wounds underneath a resident’s knee immobilizer, resulting in a serious stage 4 wound.
The resident in question was admitted to the nursing facility after breaking her right hip and having surgery. She had other health conditions like diabetes and a history of falls that already put her at risk for developing painful pressure sores.
When the resident was admitted, staff created a care plan that identified her as being at risk for skin breakdown. However, the care plan failed to address potential issues from the rigid knee immobilizer she had to wear at all times to protect her surgically-repaired hip.
Over the next few weeks, the hard plastic backing of the immobilizer was in constant contact with the resident’s skin. Even though she complained of discomfort, staff failed to check under the immobilizer because the doctor’s orders said it was to stay on at all times.
Staff discovered a large, serious pressure wound on the back of the resident’s lower right leg. From the wound location and size, they realized it was caused by the immobilizer pressing against her skin. The wound continued to worsen over the next two months.
Nursing experts who cared for the resident stated that with immobilizer orders, staff have a duty to periodically remove or adjust it and check underneath – otherwise it can rub and put too much pressure on the skin and cause injuries. Even slight movements can shift an immobilizer and create skin friction.
In this resident’s case, closer oversight and wound prevention were needed to protect her from harm related to the medical device pressing on already vulnerable skin. The nursing facility did not take these appropriate precautions as required. Sadly, the open sores resulted in significant pain, risk of infection, and reduced mobility to this elderly resident.
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