Each year, around 25,000 nursing home residents die in hospitals while suffering from sepsis, a life-threatening illness caused by the body’s response to an infection. The shame of it is that most of these infections are preventable before sepsis develops, and sepsis should always be diagnosed in its early stages by the timely intervention of a well-staffed and attentive nursing home. Once sepsis develops, it can be especially deadly for nursing home residents — those over 65 and with compromised immune systems are most at risk.
The blame for this problem was laid at the feet of nursing home protocol in a devastating 2018 report by Chicago Tribune/Kaiser Health News reporters. The investigation found that 72 percent of nursing homes in the US have been cited for not having or not adhering to an infection-control program.
How Sepsis Develops in Nursing Homes
In nursing homes, sepsis can be caused by any of the following:
- Unsanitary living conditions
- Unsanitary equipment
- Poor personal hygiene
- Infected bedsores and pressure wounds
- Poorly maintained or broken catheters
- Urinary tract infections
How Inadequate Staffing Can Cause Sepsis and Prevent Diagnosis
As sepsis is often the result of infections caused by nursing home negligence, so too can a failure to diagnose sepsis result from this negligence. Although a lack of training is behind many failures to diagnose, so too is a lack of adequate staffing, which can make the recommended care to prevent infections difficult.
Despite a federal study recommending that each nursing home resident receive 4.1 hours of nursing time per day, there are no regulations that enforce this. In a field where a facility’s most highly trained staff have turnover rates as high as 93 percent, familiarity with individual patients can also be a challenge.
Understaffing can contribute to sepsis and its diagnosis in the following ways:
- A lack of attention given to immobile patients, who need staff-assisted repositioning on a regular basis to stave off bedsores
- Inconsistent monitoring of vulnerable patients for infection
- A lack of education and training in newly-acquired staff
- A lack of familiarity with more at-risk patients
- Inexperience in dealing with sepsis
- Misdiagnosing sepsis as the flu
Signs of Sepsis
The Sepsis Alliance recommends that caregivers use the “It’s About TIME” acronym to determine if they should be concerned about sepsis. The TIME acronym stands for:
- Temperature: Is the resident’s temperature higher or lower than normal?
- Infection: Does the resident have signs or symptoms of an infection?
- Mental decline: Is the resident confused, sleepy or have difficulty waking up?
- Extremely ill: Does the resident complain of severe pain, discomfort or say that they might not recover?
If a nursing home resident has a combination of these symptoms, it could indicate sepsis, and a need for immediate treatment.
The Dangers of Undiagnosed Sepsis
About 30 percent of all patients diagnosed with sepsis die, and another 50 percent suffer from post-sepsis syndrome. These numbers are higher in the elderly and immunocompromised — and near fatal in those who don’t receive a timely diagnosis.
Sepsis has three stages:
- Sepsis: The first stage is treatable with attention and proper treatment.
- Severe sepsis: The second stage is marked by symptoms that indicate organ failure, such as decreased urine output, abrupt mood or cognitive shifts, decreased platelet count, difficulty breathing, abnormal heart rate or abdominal pain.
- Septic shock: The third stage has all the signs and symptoms of severe sepsis — plus extremely low blood pressure that doesn’t respond to simple fluid replacement. Septic shock often leads to death.
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When to Consult with an Experienced Malpractice Attorney
In a good nursing home, sepsis is often avoidable. A failure to diagnose sepsis in an accurate and timely fashion is wholly avoidable, and often comes down to cost-cutting issues within the facility’s control, such as appropriate staffing and regular monitoring.
The best course of action if you feel that nursing home negligence has caused harm to you or a loved one is to consult with skilled attorneys like those at McEldrew Purtell as soon as possible. With 30 years of experience in medical malpractice, McEldrew Purtell is well suited to evaluate the situation and help determine if the injury suffered involved acts of negligence.