At the beginning of the pandemic and ensuing lockdowns, there were documented cases of care lapses both in-house and as a result of a decline in offsite wound treatment. While none of this was intentional, workforce shortages since have only amplified the festering problem: The COVID-19 era has disrupted much of the daily routines of nurses, aides and other staff charged with keeping their facilities operating with any semblance of normalcy.

As the pandemic entered its third year in 2022, a New England Journal of Medicine study led the Centers for Medicare & Medicaid Services and Centers for Disease Control and Prevention officials to express alarm at increasing rates of falls and pressure injuries inside facilities. For example, in April 2020, rates of falls causing major injury increased by 17.5% and pressure ulcer rates increased by 41.8%. Regulators have since pressed for better safety measures.

Nearly two years later, an industry journal discovered a number of inconsistencies in reporting pressure ulcers, with almost half of the instances going unreported when listed as a secondary diagnosis.

Even now, clinicians are surprised and challenged by a noticeable surge in serious illnesses.

“We continue to see an increase in high-acuity patients and comorbidities like diabetes and cardiovascular disease,” said Amin Setoodeh, RN, senior vice president of skin health and clinical services for Medline. “This contributes to chronic wounds, and the staffing crisis has significantly impacted how we manage and prevent wounds.”

Among the current major impediments: Many skilled organizations do not have a 24/7 certified wound care nurse on staff.

“As a result, facilities now often rely on third-party organizations” for rounds, Setoodeh noted. “Unfortunately, while healthcare workers dedicated their efforts to infection prevention and helping patients remain safe during the pandemic, other aspects of healthcare delivery, including wound care, were deprioritized.

“What lies ahead is a significant knowledge gap in frontline staff, leading to wounds being misdiagnosed,” predicted Setoodeh, who called on facilities to build staff knowledge and confidence around skin health and wound care.

From the November 2022 Issue of McKnight's Long-Term Care News