Stop the Pressure Week: Why Diabetic Patients Need Specific Attention in Pressure Injury Prevention
Posted on in Medical Negligence
During Stop the Pressure Week, we are reminded of the critical importance of preventing pressure injuries, also known as pressure ulcers or bedsores, in vulnerable patients.
For people living with Type 1 or Type 2 diabetes, the risks are significantly heightened, as are the responsibilities of healthcare providers in ensuring thorough, timely, and individualised care.
Within our medical negligence team, we often see the long-term impacts when systems fail. For diabetic patients, the consequences of a missed pressure injury can be devastating, ranging from chronic wounds and infections to life-changing amputations. Many of these injuries are entirely preventable with the right approach.
Why Are Diabetic Patients at Higher Risk?
Diabetes is associated with a range of comorbidities that make patients more susceptible to developing pressure injuries. These include:
- Peripheral neuropathy, leading to reduced sensation and delayed recognition of injury.
- Peripheral vascular disease, impairing blood flow and slowing healing.
- Compromised immune function, increasing infection risk.
- Reduced mobility, especially in patients with diabetic complications or co-existing conditions.
These factors, taken together, mean that diabetic patients not only develop pressure injuries more easily but also heal more slowly, requiring a more proactive and multidisciplinary approach to care.
What Good Care Looks Like
Healthcare professionals have a duty to identify and mitigate the risks of pressure injury in all patients, but particularly those with diabetes. Key steps include:
- Detailed and Accurate Risk Assessments: Regular use of validated tools (like the Waterlow or Braden scale) must take diabetes-specific factors into account.
- Offloading and Pressure Relief: Diabetic patients require early and specific offloading advice, especially if foot ulcers or neuropathy are present. Pressure-relieving equipment (such as specialist mattresses or heel protectors) must be provided and correctly used.
- Regular Repositioning: For patients with limited mobility, turning schedules must be rigorously followed and documented.
- Early Involvement of Tissue Viability Nurses (TVNs): At the first sign of skin damage, prompt referral to a TVN can prevent progression and ensure appropriate wound care.
- Multidisciplinary Involvement: Coordination with endocrinologists or diabetic specialist teams is essential. Their input is critical given the metabolic challenges that impair wound healing.
Failing to meet these standards can lead to a patient deteriorating quickly, and in some cases, irreversibly.
When Things Go Wrong: A Legal Perspective
If a diabetic patient suffers a pressure injury due to substandard care, there may be grounds for a medical negligence claim.
We typically investigate the following:
- Was the risk assessment carried out properly?
- Did it recognise the added risks diabetes presents?
- Was appropriate equipment provided in a timely manner?
- Were offloading techniques used and documented?
- Were repositioning and monitoring protocols followed? Were any lapses clearly recorded?
- Was escalation to a TVN or diabetes specialist made promptly? If not, was there a clear justification?
- Were delays in diagnosis or treatment a contributing factor? This is particularly important given the slower healing rate in diabetic patients.
If any of these areas fall below the accepted standard of care, and a patient suffers avoidable harm as a result, they or their family may be entitled to compensation. A successful claim can also prompt vital changes to care practices to help prevent further incidents.
Conclusion
This Stop the Pressure Week, the theme “What matters to me is…” invites us to reflect on individual patient needs. When it comes to diabetic patients, what truly matters is recognising that their care must go beyond standard risk assessments. Recognising unique vulnerabilities and co-morbidities is vital in the prevention of pressure injuries.
With thoughtful, timely, and coordinated care, most pressure injuries are preventable, even in high-risk individuals.
If you or a loved one has suffered a pressure injury while under medical care, our specialist medical negligence team at Tozers LLP is here to help you understand your options and investigate the care that has been received.