152 severe bedsores reported at Nova Scotia long-term care facilities

The Department of Health ordered all long-term care homes to report pressure ulcers. The data comes as police investigate the case of Chrissy Dunnington, who died with a severe bedsore.

Health Department gathered new data following case of Chrissy Dunnington, who died with severe bedsore

Bedsores, or pressure ulcers, occur when pressure is applied to the skin for long periods of time — such as when a person is bedridden. (Richard Buchan/Canadian Press)

The province revealed Thursday there are at least 152 cases of severe bedsores at Nova Scotia long-term care facilities, data gathered as police investigate the death of a woman whose family says she suffered from a "horrific" case.

Last week, Health Minister Randy Delorey ordered long-term care homes to report all incidents of bedsores, also called pressure ulcers.

The province said there were 152 reported cases of Stage 3 or 4 pressure ulcers. By the time a pressure wound reaches those most severe stages, the skin is open, oozing and bone or muscle may be visible.

Corrine McIsaac, a registered nurse with a doctorate in wound care, told CBC News last week that 95 per cent of all pressure injuries are preventable and said by the time the wounds reach Stage 3 or 4, it's often too late to make a difference. 

Halifax Regional Police are currently investigating the circumstances surrounding the death earlier this year of Chrissy Dunnington, a long-term care resident at a facility in Halifax.

Chrissy Dunnington died from an infection related to an untreated pressure ulcer. (Submitted)

On Jan. 22, Dunnington's family received a call to say she had a fever. The next day staff said they thought she had an infection related to a bedsore that had first been noticed in October.

Dunnington was taken to hospital, where the family learned she had a bedsore on her backside that was the size of a fist and went right to the bone. She died March 22. 

Dunnington was living in Parkstone Enhanced Care, a long-term care facility owned by Shannex.

In a statement emailed to CBC, Shannex spokesperson Katherine VanBuskirk said in June they reported 22 cases of Stage 3 and 4 bedsores to the Department of Health and Wellness at their 16 nursing homes with 1,392 residents.

One-time reporting not sufficient

In a news release Thursday, the province said that starting the first week of July, wound-care experts will visit those facilities that have reported severe bedsores. The province said those residents suffering Stage 1 or 2 pressure ulcers in those facilities will also be seen.

McIsaac said the province's one-time order to report all bedsores is an inefficient way of dealing with the problem. She said this type of reporting needs to be standardized and should be done on a monthly, or even weekly, basis.

Modifying certain factors for patients, such as positioning, turning and nutrition can prevent bedsores, she said. 

The province said it is taking other steps including implementing standardized wound care in long-term care facilities and working on prevention and management protocols for facilities.

Nurses' union calls for staffing standards

Nurses' union president Janet Hazelton says long-term care facilities need better staffing.

Janet Hazelton, president of the Nova Scotia Nurses' Union, said long-term facilities aren't staffed with enough nurses to meet the care needed.

Hazelton said patients are receiving an average of 3.45 hours of care per day, below the minimum standard of 4.1 hours required to prevent deterioration, according to research.  

She said the province should update the Homes For Special Care Act, which hasn't been changed since 1989.

"If we are going to change the situation in our facilities then we need to change the staffing," Hazelton said at a press conference on Thursday. "We can't expect the same staffing levels that we had in 1989 to be OK in 2018.

"And this is just the minimum, that's what we're asking for."

Delorey said there is no plan to change to the legislation.

"What we do need right now is to go to make sure that those residents in our long-term care facilities that have these conditions are getting the care and the supports and the treatments that are appropriate for their condition at that time," he told reporters on Thursday.

Bedsores, or pressure ulcers, occur when pressure is applied to the skin for long periods of time — such as when a person is bedridden. According to Nova Scotia 811's website, the ulcers can get quite large and, if left untreated, can even go down to the bone. 

Pressure ulcers happen most often on pressure points such as on the tailbone, shoulder blades, side of the hip joint, ankle, knee, elbow and back of the heel.

To heal, pressure must be kept off the area and the wound must be kept clean and dry, according to Nova Scotia's medical advice line. Larger, deeper bedsores need special care and can take a long time to heal.