Voss Anne Coble, Bender Stacy A, Ferguson Maree L, Sauer Abby C, Bennett Richard G, Hahn Peter W
Ross Products Division, Abbott Laboratories, Columbus, Ohio 43215, USA.
J Am Geriatr Soc. 2005 Sep;53(9):1587-92. doi: 10.1111/j.1532-5415.2005.53462.x.
More than 20% of residents who have been in long-term care (LTC) facilities for 2 or more years will develop at least one pressure ulcer (PU). Residents suffer pain, disfigurement, and decreased quality of life, and their risk of illness and death increases. LTC facilities face censure from residents, their families, and surveyors and the threat of expensive lawsuits. Lawsuits are typically based on contentions of residents with a PU--or their advocates--that the LTC facility was negligent and failed to provide the care that, by industry standards, it must provide to prevent or manage such wounds (managing pressure, incontinence, and nutrition). In this article, data from 1999 and 2002 are presented, showing that lawsuits related to PUs are increasingly common and costly for LTC owners and care providers. Residents realized some type of recovery against the facility in 87% of the cases (verdicts for the resident plus settlements) and were awarded amounts as high as $312 million in damages. Even LTC administrators who believe that care in their facility equals or exceeds industry standards often settle lawsuits out of court to avoid jury verdicts. The data also show that jury awards were highest for PUs caused by multiple factors and that the highest awards for PUs caused by a single factor were seen when that factor was inadequate nutrition. LTC providers can help improve the health and quality of life of their residents, improve survey results, and minimize their risk of expensive lawsuits by developing, implementing, and documenting a plan of basic measures to prevent PUs.
在长期护理（LTC）机构中居住2年或更长时间的居民，超过20%会至少患上一处压疮（PU）。居民会遭受疼痛、毁容，生活质量下降，患病和死亡风险也会增加。LTC机构面临居民、其家属和调查员的指责，以及昂贵诉讼的威胁。诉讼通常基于患有压疮的居民——或其支持者——的主张，即LTC机构存在疏忽，未能按照行业标准提供预防或处理此类伤口（控制压力、失禁和营养）所需的护理。本文展示了1999年和2002年的数据，表明与压疮相关的诉讼对LTC机构所有者和护理提供者来说越来越普遍且成本高昂。在87%的案例中（居民胜诉加上和解），居民从机构获得了某种形式的赔偿，赔偿金额高达3.12亿美元。即使是那些认为其机构的护理等同于或超过行业标准的LTC管理人员，也常常选择庭外和解以避免陪审团裁决。数据还显示，由多种因素导致的压疮，陪审团判给的赔偿最高；而当单一因素是营养不足时，由单一因素导致的压疮所获赔偿最高。LTC提供者可以通过制定、实施和记录预防压疮的基本措施计划，来帮助改善居民的健康和生活质量，提高调查结果，并将昂贵诉讼的风险降至最低。
