Pressure ulcers — often referred to as “bed sores” — are a common and frequent sign of nursing home abuse and neglect. Pressure ulcers are ranked for level of severity in stages — Stage I being the least severe and Stage IV + being the most severe.
Recently, wound care experts have criticized the current staging system as misleading. Experts believe the staging system implies that these wounds progress through stages (i.e. starting at Stage I and progressing eventually to a Stage IV + if not properly treated.). In reality, an individual can develop a Stage IV pressure ulcer without ever being in a “Stage I” phase. Experts are recommending that instead of categorizing pressure ulcers in stages, the wounds should instead be categorized by the depth of the wound, location, size, wound base description and drainage.
Another reason that the staging system fails is because pressure ulcer assessments are very subjective. Meaning, one medical provider might assess the wound differently from a second medical provider. When medical providers assess the same wound differently, it is possible to see the same pressure ulcer documented as a Stage II and later a Stage III within hours of each assessment. Using objective information about the wound instead, specifically the depth, will help distinguish the correct pressure ulcer stage. Wound depth should be documented at every wound assessment.
Until a more objective system is put into place, do not be surprised if your loved one has their pressure sore diagnosed as a Stage III only to have it increased to a Stage IV or decreased to a Stage II within a matter of hours by a different medical treater
. The important thing, is that the size, depth and location of the wound are properly documented in the medical record.
