Bed sores, also referred to as pressure sores, which may occur in elderly patients at nursing and senior citizen homes across the island, are becoming somewhat of a concern for Ministry of Health officials.
This was one of a number of topics discussed at a workshop targeting owners and operators of nursing homes, senior citizen homes and the Alternative Care of the Elderly Programme, held in the auditorium of the Queen Elizabeth Hospital (QEH) on Monday.
Co-ordinator of the Ministry of Health’s Inspection and Advisory Committee for Nursing Homes, Angela Crawford, told the 80 participants that her role was to bring standards, protocols and procedures under one umbrella.?? She explained that there were three things she looked for when conducting inspections: bed sores: medication errors and the licensing and re-licensing of professionals and institutions providing care for the elderly.
Mrs. Crawford, a nurse with 44 years of experience, said she was particularly concerned about cases of bed sores, adding that they were a bad reflection on the persons hired to deliver care, as well as the nursing homes.
"There are a lot of new things that you can put on bed sores. You shouldn’t let them get to the point where, when I look at the patient’s coccyx, that I can see bone. It hurts me because that is not how we should exit this world. I want, if nothing else, for you to pay attention to those who come to you with bed sores and when a person comes to you with a bed sore, do not keep it as a secret. Inform the ministry … because if it gets worse, and there is no documentation [the consequences may be dire] …. Recently, I heard there was a family who was suing because of a bed sore," she informed the gathering.
Consultant in Clinical Risk Management at the QEH, Fiona Leacock, pointed out that many of the elderly patients, who came through the Accident & Emergency Department with bed sores, came from nursing homes and the wider community. But, she said, instead of pointing fingers, those charged with the care of the elderly needed to be educated on all of the contributory factors such as diabetes, hypertension and certain medications (which cause thinning of the skin), that could lead to bed sores.
She said the hospital had implemented a number of measures to reduce the incidences of pressure sores by having "turn teams" that assisted patients by moving them periodically. In addition, Ms. Leacock noted the QEH had also invested in hoists to lift heavier patients, in an effort to get them off pressure areas which were more likely to break down, thus resulting in pressure or bed sores.
Mrs. Crawford explained that the application of Continuous Quality Improvement (CQI) techniques in nursing homes, would seek to eliminate such occurrences. CQI is a management philosophy used to improve materials, services and products. In health care, it involves doctors starting with administrative processes then moving on to clinical processes; using measurement at every step and building teams which, it states, has long-term advantages for the organisation. It further states, that leadership is key to achieving wide commitment to improving quality.
Mrs. Crawford said there was inadequate training in this area and she added that the directorate of the Ministry of Health was committed to seeing improvements in the quality of health care offered to all Barbadians and visitors alike.