Addressing pressure injuries in nursing home residents during COVID-19
A rural nursing home’s approach using telehealth and clinical education to improve care outcomes
By Medline Newsroom Staff | December 15, 2020
Approximately 60 million people in the United States reside in rural areas, accounting for 19% of the US population overall. Several studies have found that compared to urban and suburban areas, rural communities have less access to health care services.
To make matters more complicated, COVID-19 continues to plague nursing homes. In Colorado where there has been more than 200,000 COVID-19 cases, Rocky Ford-based Pioneer Health Care Center experienced an outbreak of cases like many other nursing homes around the country. For 45 days, their residents primarily stayed in their rooms, leading to increased risks for pressure injuries as residents spent more time sitting down.
Despite being in a rural market of less than 4,000 people and having limited access to their usual in-person resources, the nursing home has found new ways to improve how they practice skin care with residents. The number of Pioneer Health residents experiencing issues with wounds fell from nine to two since implementing these measures in May.
The organization identified three key tactics leveraged during the pandemic to help provide high quality skin health and cut down the number of wounds in residents.
1. Look at the holistic health of residents
A breakdown in mattress support can lead to serious breakdown in skin integrity, putting residents at risk for pressure injuries. In 2018, Medline evaluated more than 20,000 mattresses at healthcare facilities across the country and more than a third had visible staining or thinning, and more than half required immediate replacement. In their journey toward preventing pressure injuries from developing, Pioneer collaborated with Medline to assess and check for damages in their outdated mattresses. Around 95% of the mattress were poor quality. They decided to replace the mattresses and quickly saw an increase in resident satisfaction, as well as improved health in residents.
2. Increase telehealth usage
Pioneer is based in a rural market which means its care resources can be an hour or so away. To overcome this challenge, the healthcare provider has been partnering with a telehealth group out of Denver since before the pandemic. But when COVID-19 hit earlier this year, telehealth began playing a much stronger role within their care plans. The facility has four care units with unique resident care needs, and each one has their own iPads to conduct telehealth meetings with essential care team members, like physicians and dieticians.
3. Greater focus on care planning
Pioneer has received F-tags in past surveys for insufficient care planning, as frontline staff were not educated on how to identify certain type of wounds. Now, the organization has put more emphasis on nurse education to ensure they can identify wounds and care techniques.
“Our frontline staff work tirelessly to provide care and with the right training in place, it will only help create a culture that’s focused on quality improvement,” says Marci Davis, LPN, Nurse Manager, Pioneer Health Care Center. As an experienced wound care nurse, she has played an integral role in developing resources to enhance clinical knowledge. “To help empower our frontline staff, we have revamped our nurse orientation to include both online and in-person education on wounds and have also made wound care a focus during monthly clinical meetings.”
As part of their care planning initiatives, Pioneer is also putting greater focus on tracking resident care. “We created a calendar to make sure all residents get their skin checked and our frontline staff record when a checkup was performed. This makes it easier for us to pull up weekly skin assessments in our morning meetings and track any abnormal findings.”
Learn about how Medline is helping customers improve skin health outcomes.