Stopping pressure ulcers—before they start

Nursing Homes, May, 2004

Mogensen: Yes, there are. High-frequency ultrasound scanning isn't limited to detecting potential decubitus ulcers. It also allows us to see other occurrences under the skin. In fact, it was used to prevent a lawsuit at one nursing home when the family of a resident with a superficial bruise was claiming the injury was caused by abuse. Scanning the subcutaneous tissue under the bruise failed to show the deep trauma that would have been consistent with the family's allegation. When the scans were showed to the plaintiff's attorney, the claim was dropped.

Hertig: It's also excellent for documentation. Let's say you have a resident with a pressure ulcer during a survey and, therefore, you have to document that it's improving. As mentioned earlier, without this technology that is an extremely subjective process. For one thing, sometimes wounds superficially look like they're getting worse when actually they're improving. Other wound-measurement techniques simply are not precise enough.

Mogensen: Better pressure ulcer prevention and assessment also should help to keep skyrocketing liability insurance premiums down. We're hoping that as this technology catches on, it will help both skilled nursing facilities and their insurance carriers to drive down costs.

Hertig: It certainly should help keep premiums from rising, since pressure ulcers have so often been the culprits in litigation. We're hoping that the long-term care insurance industry will become aware of this technology. I'd think it would be of great interest to them to insure facilities that use it. It helps everyone, from the residents and their families to staff to owners to insurers to third-party payers. It allows information that was previously unknown to be managed much more closely.

Nursing homes have been dealing with this problem forever. Wouldn't the best solution be for pressure ulcers never to develop? Many products are available for managing pressure ulcers after they occur. We want to shift the approach from treatment to prevention, allowing nursing homes to take control and improve their residents' quality of life.

RELATED ARTICLE: Soft-Tissue Management Interventions With Use of High-Frequency Ultrasound

These protocols are to be used as a guideline for a facility utilizing high-frequency ultrasound for evaluation of the soft-tissue status of an individual. Advanced Vital Services assumes no responsibility for any unauthorized use of these suggested protocols.

The following protocols may be used in response to the phasing classification supplied with the Longport High-Frequency Ultrasound Scanner. In the event that an ultrasound procedure results in the collection of a scan that reveals the interpretation of a Phase 1, 2, 3 developing pressure ulcer, or Phase F (friction ulcer), the following protocols may be followed.

PHASE 1 PRE-ULCER

* Pre-albumin level (serum albumin levels accepted if available).

* Prescribe multivitamin and mineral supplement.

* Granulex or skin prep to bilateral heels qd with soap-and-water wash between applications.