New Updates to Decubitus Ulcer Staging (from Stage 1 to Stage 4)

Recently, the NPUAP (National Pressure Ulcer Advisory Panel) changed the way healthcare providers across the country stage decubitus ulcers. The term ‘pressure ulcer’ is now being replaced with ‘pressure injury’, which better designates the description of the wound as an actual injury. Also, decubitus ulcers will now be staged 1 to 4 with Arabic numerals in lieu of Roman numerals. Hospitals and nursing homes are updating their decubitus ulcer staging policies in accordance with the NPUAP’s guidelines.

A Brief Description of Decubitus Ulcers and Pressure Injuries

Decubitus ulcers (also known as bedsores, pressure injuries or decubitus wounds) are skin breakdown due to unrelenting pressure on a specific area of the patient’s skin. Usually occurring in elderly patients who cannot move themselves, if a nurse or aide fails to move the patient out of bed for a long period of time, the patient’s skin will start to fall apart. This is the beginning of a pressure sore, which is usually staged as a red spot or a stage 1 wound. If the nurse continues to neglect the patient, the decubitus ulcer will worsen. Maybe it will get infected from nearby urine or fecal matter if the patient is unable to control their bladder and bowel. This will cause the wound to break down further into a stage 3 or stage 4 decubitus ulcer. A stage 4 decubitus is the worst wound on the scale. If a patient develops a stage 4 decubitus ulcer inside a hospital or a nursing home, answers must be given to the victim’s family as to how this happened.

Staging of Decubitus Ulcers

Decubitus Ulcers form due to unrelieved pressure. A Decubitus Ulcer is staged from 1 to 4.

Do Words Matter? Pressure Injury vs. Pressure Ulcer?

We think so. Decubitus ulcers have been deemed a never event in healthcare by Medicare, meaning a pressure ulcer really should not form inside a hospital or a nursing home. By the NPUAP now calling these wounds injuries instead of ulcers, it allows lay people to understand the effect these wounds have on the victim. A decubitus ulcer truly is a pressure injury which will negatively impact the victim’s health.

Stage 4 Decubitus Ulcer vs. Stage IV Decubitus Ulcer

Official medical records will now stage a decub wound as a ‘4’ rather than a ‘IV’. This will likely make it easier for healthcare providers and patients to understand the depth of the wound. For example, a stage 1 decub wound is just a red spot on the skin, while a stage 4 decubitus ulcer is a very serious, deep wound which can result in sepsis and wrongful death.

Stage 4 Pressure Ulcer Diagram

A stage four pressure injury wound is the most severe pressure ulcer one can have.

If you or a loved one developed a stage 4 decubitus ulcer in a hospital, nursing home or assisted living facility, contact our decubitus ulcer lawyers today. Call us now at 561-316-7207 for a free consultation.


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