The measures we take to keep residents safe from exposure to COVID-19 can have unintended side effects. Due to the isolation and lack of activities and movement, residents are at higher risk for pressure injuries, weight loss and dehydration.
To help avoid these outcomes, caregivers should first ensure that residents have the appropriate pressure redistribution support surface for the bed and wheelchair. Secondly, consistent assignments for your caregivers can reduce exposure and assist them in developing a routine for their residents. The routine should ensure that residents have a wellness check every two hours.
During the wellness check, the caregiver should:
- Offer fluids
- Offer snacks/food
- Provide toileting and incontinence care
- Turn and reposition the resident
- Off-load the heels, and
- Ensure the call light, fluids and needed items are in reach
During the night shift, try as little as possible not to disrupt the resident’s sleep. Uninterrupted sleep is imperative for maintaining immune system health and for fighting infection. Providing an appropriate pressure redistribution mattress, an overnight incontinence product and heel elevation can minimize disruption of sleep by extending turning and incontinence management intervals. The residents should still receive visual checks every two hours. In addition, utilize amber tone lighting when you interact with the residents at night. Amber tones promote melatonin production to promote sleep while white lights will stimulate serotonin, leading to resident wakefulness.
Thirdly, leverage the use of telehealth capabilities. This will provide your nurses virtual bedside access to wound care specialists to assist them with assessing and properly managing wounds. When a wound is showing signs of infection, increasing the risk for sepsis, a telehealth wound care specialist can help triage the need for sending a resident out for emergent surgical debridement.
Lastly, the psychological effects of being isolated and away from loved ones can be devastating for a resident, leading to depression and withdrawal. These wellness and telehealth checks can provide consistent interaction and peace of mind for the resident.
Jeri Ann Lundgren, RN, BSN, PHN, APRN, CWS, CWCN, CPT, is a certified wound care specialist providing wound care consultation and telehealth wound support for post-acute care providers. Ms. Lundgren is the president of Senior Providers Resource.