Rest home health code breach

A rest home has been found in breach of the health code after an elderly woman died of an infection resulting from bedsores.

Deputy Health and Disability Commissioner Rose Wall yesterday released a report finding the rest home and a registered nurse in breach of the Code of Health and Disability Services Consumers’ Rights over the woman’s care.

The woman, in her 80s, was admitted for respite care in 2014 to a rest home contracted by an unnamed DHB.

She developed blisters on her heels and a pressure sore over her sacrum at the base of her spine. Over the following three months the wounds were assessed regularly and the conditions described on wound care plans by staff.

Descriptions of the sacral wound contradicted each other over how well the wound was healing.

There is also dispute over how many times the clinical and nurse manager tried to contact the regional wound care specialist for advice.

One day in 2015, nursing staff noted the woman was unwell, with rapid breathing, high blood pressure, tempera- ture and heart rate. She was rushed to hospital and treated for suspected sepsis with antibiotics. Although she initially showed signs of recovery, she died a few days later.

A GP stated at the time that the woman’s heel and sacral wounds were likely to be the cause of her acute deterioration.

The deputy commissioner recommended the rest home arrange training for its staff on wound care, effective communication with family members, GPs and other clinical personnel and clinical documentation skills.