Page Section: Centre Content Column
Care of pressure area in obese patient (07HDC18556)
Download Care of pressure area in obese patient (07HDC18556) (PDF 7Kb)
(07HDC18556, 23 December 2008)
Rural hospital ~ Registered nurse ~ Hospital manager ~
Obesity ~ Pressure area care ~ 4(1), 4(3)
A 72-year-old woman was admitted to hospital because of concerns
from her family and her general practitioner about her lack of
mobility. She was previously being cared for by her family at home,
and suffered from morbid obesity, diabetes, hip pain, high blood
pressure, gout, and breathing difficulties. She had been bedridden
for months, getting out of bed only to go to the toilet.
During her time in hospital, she developed a large necrotic
sacral pressure sore, renal failure and septicaemia. She was
transferred to a larger hospital for treatment, but her condition
deteriorated and she died a few days later.
It was held that throughout her stay at the hospital, the
woman's pressure area care was poorly documented and inadequately
planned. Despite policy, there was no formal initial assessment
that would warn of a high risk, and the subsequent assessment was
significantly inaccurate. When damage was noted to her sacrum,
inadequate measures were taken to reduce the risk of further
damage. Furthermore, documentation of the care provided was poor,
especially with regard to pressure area care, and instructions for
turning her were not followed. The hospital breached Rights 4(1)
and 4(3).
It was also held that the nurse manager, a registered nurse, was
responsible for ensuring that patients were provided with care of a
reasonable standard. She was accountable for the poor standard of
documentation relating to pressure area care, and the lack of a
structured plan to manage and re-evaluate the risk to the woman's
pressure areas during her admission. The nurse manager failed to
ensure that pressure area care was provided with reasonable care
and skill, and in accordance with the patient's needs, and breached
Rights 4(1) and 4(3).