Pressure injury and bed sore care in Jefferson County.

What to know about pressure injuries

Anyone who cannot easily change position is at risk, at any age. That includes people recovering from a hip fracture or major surgery, people with a spinal cord injury or advanced multiple sclerosis who use a wheelchair full time, people weakened by a stroke, and people in the later stages of dementia or another serious illness.

Loss of feeling matters as much as loss of movement. Someone with nerve damage may not notice the ache that tells the rest of us to shift. Very thin people have less padding over bone. People who wear oxygen tubing, splints, braces or casts can develop the same kind of injury wherever a device presses on skin. Several of these risks often appear together in one person.

What the treating clinician looks at

After the assessment, the treating clinician writes orders and explains them to the people who will carry them out. A pressure injury plan usually has several parts:

• Wound orders: how the wound is cleaned and covered, and how often the dressing is changed
• Pressure relief: the mattress, cushion or heel protection to use
• Positioning: which positions to use, which to avoid and how often to change
• Skin care: keeping the area clean and dry after incontinence
• Follow-up: when the wound will be checked again

Gateway follows up on the supply and equipment orders and shares the plan with the caregivers, home health nurses or facility staff involved.

Pressure injury and bed sore care in Jefferson County

Distance changes pressure injury care in Jefferson County. A long drive to a wound clinic is hard on someone who should not be sitting on the wound, and it may call for special transport. Care brought to the home avoids that. Because visits to outlying areas are planned ahead, Gateway follows up on the treating clinician’s supply orders with the next visit date in mind, to help keep enough dressings in the house until then.

South of the Meramec River, St. Louis County gives way to Jefferson County, a wide stretch of hills, creek valleys and growing towns. Interstate 55 lines the east side through Arnold, Imperial, Barnhart and on to Festus and Crystal City. Route 30 serves High Ridge and House Springs in the north, and Route 21 heads down to Hillsboro, the county seat, and De Soto. Much of the county is rural once you leave those corridors. Home and facility visits matter here because the alternative is often a long drive on winding roads for every appointment.

When care happens at home

A home visit shows the treating clinician things an office visit cannot: the mattress the person actually sleeps on, the chair they sit in most of the day, and how transfers happen in that room. For a pressure injury, those details are often the cause of the wound.

Gateway schedules the visit with a partner clinician once availability is confirmed for your address. Leave the bed and chair set up as they normally are. If the person uses a cushion, pillows or a lift, keep them in place. The clinician decides how often to return based on how the wound is doing.

In a facility

People often arrive at a rehabilitation center with a pressure injury that began in the hospital, or with fragile skin after surgery and days in bed. Therapy adds a new question: how long can the person sit in a wheelchair or on a mat without harming the wound? The treating clinician, nursing staff and therapists work that out together.

Rehab stays are short, so planning for what comes next begins early. Gateway can help arrange for wound care to continue after discharge, whether the person goes home or to another facility, so that orders, records and supplies follow them and care does not start over.

Changes to report

Once a pressure injury is being cared for, the treating clinician needs to hear about changes in the wound between visits. Report any of these:

• The wound looks wider or deeper than it did at the last visit
• Black, brown, gray or thick yellow tissue appears
• Drainage increases, soaks through the dressing or changes color
• A new or stronger odor that remains after the wound is cleaned
• The edges lift or a pocket seems to open under the skin

Call 911 for bleeding from the wound that will not stop, or if the person collapses or cannot be roused.

How primary care fits in

A new pressure injury is often a sign that a person’s overall health has changed. Perhaps they have become weaker, are sleeping most of the day, or a long illness such as dementia or cancer has advanced. Caring for the wound without asking why it appeared now misses part of the picture.

That is the reason Gateway arranges wound care and primary care side by side. The primary care clinician can reassess the person’s conditions, talk with the family about goals and bring in palliative or hospice care if that fits. The wound clinician can then match the wound plan to those goals, whether that means working toward closure or keeping the person comfortable.

Primary care at home in Jefferson County →

How to get started in Jefferson County

For a resident of a nursing home, assisted living or memory care community in Jefferson County, a request for pressure injury care can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.

When you call about care in Jefferson County, tell us the town and ZIP code first, since Arnold (63010) and De Soto (63020) are very different drives. Then give the street address, turn-by-turn directions if the home is rural, and a phone number that gets a signal there. Mention steep or unpaved driveways. Visits are planned by area, and Gateway arranges care in Arnold, Imperial, Festus and Crystal City as well as neighboring Fenton and Oakville. Bad weather on hill roads can occasionally move a visit, and we will call if it does.

• County: Jefferson County, Missouri
• ZIP codes: 63010, 63028, 63019, 63052, 63012, 63050, 63020, 63049, 63051
• Nearby hospitals: Mercy Hospital Jefferson in Festus; Mercy Hospital South; SSM Health St. Clare Hospital in Fenton (not affiliated with Gateway)
• Nearby communities: Arnold, Festus and Crystal City, Imperial, Fenton, Oakville
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Jefferson County

Read the full guide to pressure injuries, or see everything Gateway arranges on the mobile wound care in Jefferson County page.

• Diabetic foot ulcers
• Venous leg ulcers
• Arterial and mixed wounds
• Non-healing wounds
• Post-surgical wounds
• Reopened (dehisced) surgical wounds
• Surgical site infections
• Skin tears and traumatic wounds
• Wounds with lymphedema
• Skin graft aftercare
• Wound VAC (NPWT) follow-up
• Pressure injury and bed sore care in Arnold
• Pressure injury and bed sore care in Festus and Crystal City
• Pressure injury and bed sore care in Oakville

Common questions