Skin breakdown: facility hit with substantial judgment for poor nursing care, documentation.

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The Supreme Court of Mississippi approved a $1,000,000 judgment against a nursing home after a resident died with a six by ten inch decubitus ulcer on her coccyx. The judgment was reduced to $500,000 under Mississippi's cap on damages against public healthcare facilities.

Immobile patients who are susceptible to skin breakdown must be turned every two hours as a preventative measure before skin lesions develop, according to the nursing experts whose testimony was endorsed by the court.

This resident's chart showed she was turned only at three to eight-hour intervals, below the standard of care for pressure relief in vulnerable patients. She apparently was not turned often enough even after decubitus started.

She remained in one position for more than sixteen hours, which was right before her lesion progressed to Stage III, according to her chart.

Good nutrition is also essential. A resident's refusal to eat must be addressed. Antidepressant medications are a recognized appetite stimulant for geriatric patients, the court said.

Good hydration is also essential for skin integrity. Daily fluid intake of 2,000...

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