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“Is failure to turn a critically ill patient every 2 hours and not informing the family of worsening bed sores, a serious violation of ICU level care expectations?” That’s a question from one of our clients that I will answer today.

My name is Patrik Hutzel from intensivecarehotline.com and I have another quick tip for families in intensive care.

So, one of our clients asked us to do a medical record review and that’s one of the questions that came out of the review for their loved one that was in intensive care.

So, “Is failure to turn a critically ill patient every 2 hours and not informing the family of worsening bed sores a serious violation of ICU level care expectations? And clearly, is it nursing or medical negligence?” So, yes, absolutely. Failure to turn a patient in ICU or immobile critically ill patient every 2 hours and not informing the family of worsening bed sores is a very serious violation of standard ICU level care.

Here’s why. Turning an immobile patient, every 2 hours is standard protocol because pressure injury prevention is a critical aspect of ICU nursing care, especially for immobile and ventilated patients. In this situation, the patient was ventilated.

The standard of care is to reposition patients every 2 hours to prevent pressure sores, and ulcers. Not doing so can lead to Stage 3 or Stage 4 pressure ulcers, which are considered never events. Serious reportable events that should never happen in a hospital setting.

Next, bed sores are a sign of neglect. Development or worsening of bed sores in the hospital can be evidence of neglect or substandard care. In many jurisdictions, hospital acquired Stage 3 or 4 pressure ulcers must be reported to state and local health departments or regulatory agencies.

Next, failure to inform family breaches ethical and legal duty. Families have a right to be informed of significant changes in the patient’s condition. Not telling the family about worsening bed sores violates informed consent, transparency, and could be seen as an attempt to cover up negligence.

What can you do? Well, request documentation of turning schedules and wound care notes from the medical chart. Document everything, dates, what you observed, what you were told or not told, who you spoke to. Consider filing a formal grievance or complaint with the hospital’s patient advocate, risk management department, but I would go as far as make a complaint to hospital executive, that’s how serious it is.  You can also file a complaint with the state health department or in your local jurisdiction health commission or even seeking legal advice if you suspect neglect or harm.

So, severe pressure sores also in ICU, when patients go on inotropes or vasopressors, that’s a vasoconstrictor. A lot of patients in ICU are on vasopressors and inotropes because they are a vasoconstrictor. The skin is not as well perfused as for a healthy person, that makes it even more risky to develop pressure sores. Sometimes when patients are on high amounts of inotropes, their skin turns purple. So, therefore, it’s even more important to turn every 2 hours.

Many patients in intensive care now have air mattresses, but that still means patients need to be turned every 2 hours. It doesn’t take that away, just minimizes the risk. That is all.

So, I hope that helps understand what minimum requirements are in intensive care and you should be highlighting them. When we talk to clients all over the world, a lot of family members of our clients have pressure sores in ICU, that’s simply not good enough. That is simply not good enough. Pressure sore, like I said, is a never event. It’s a never event, should never happen, must never happen.

So, I hope that helps you understand what expectations are and what the minimum standards are.

I have worked in critical care nursing for 25 years in 3 different countries, and I certainly know all about pressure area care in intensive care. I’ve looked after hundreds, if not thousands, of critically ill patients and their families. It’s not only that you need to do pressure area care, you need to do good pressure area care, which means when you turn them, give the patient a backwash, put cream on their back, do percussions on their back, so skin gets really perfused.

The devil is in the detail. Do all of that to and you can expect all of that if you are watching this and you have a family member in intensive care or a loved one in intensive care, you should expect that. Very clearly, there is no room for negotiation.

Because I have worked in critical care nursing for 25 years in 3 different countries where I worked as a nurse manager for over 5 years in critical care and I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com.

I can very confidently say that we have saved many lives for our clients in intensive care. You can verify that on our testimonial section at intensivecarehotline.com and you can verify it on our intensivecarehotline.com podcast section at intensivecarehotline.com where we’ve done client interviews.

Our advice here is absolutely life changing. It’s absolutely life changing. Like I said, you can verify that on our testimonial section and on our podcast section with client interviews. We have helped hundreds and hundreds of members and clients over the years to improve their lives instantly when they have a loved one, critically ill in intensive care to make informed decisions, have peace of mind, control, power, and influence, making sure their loved ones get best care and treatment always.

That’s why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses on your behalf. When I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care. I can also set you up with the right questions to ask. It’s much better if I asked them, so that I can counter questions straight away, depending on what they’re saying. We can also get on a three-way call with doctors and nurses and ask the right question and you can gauge their response if they have anything to hide, and I can hold them accountable. I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, if you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all your questions intensive care related. In the membership, you also have exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded. All of that will make sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always.

All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care, like, comment, subscribe, share the video with your friends and families.

I also do a weekly YouTube Live where I answer your questions live on the show. You will get notification for the YouTube live if you are a subscriber to my email newsletter at intensivecarehotline.com or if you are a subscriber to my YouTube channel here.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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