Risks for Amputation in Long-term Care Facilities During the Pandemic

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By Tracy Rairigh

Long-term care facilities provide a place for rehabilitation, restoration, or ongoing care services for patients needing around-the-clock care. They also provide assistance with activities of daily living for patients who are unable to perform these activities by themselves. Most long-term care facilities have a high percentage of bedridden residents or those with limited mobility, and many are experiencing an increase in the number of patients with diabetes.

 

One serious complication of diabetes and limited mobility is the risk of nonhealing wounds, which can lead to amputation. By closely monitoring changes in skin health, healthcare professionals can help minimize the risks of amputation.

 

Throughout the COVID-19 pandemic, healthcare professionals in hospitals, wound care clinics, and nursing facilities have had to adjust their methods to meet the rising health requirements. While healthcare facilities must follow current guidelines for personal protective equipment and social distancing, the intimate nature of long-term care makes this more challenging.

The Risk

Seniors and those with diabetes are at higher risk for developing wounds. People with type 2 diabetes who have not been able to control their condition through diet and exercise have a higher likelihood of delayed wound healing. This is caused by elevated glucose levels, which can lead to difficulty fending off infection.

 

Diabetic foot ulcers and peripheral arterial disease (PAD) can cause wounds that lead to uncontrolled infection and ultimately amputation, and bedridden residents can suffer from pressure ulcers if they unable to adjust positions on their own or care providers are not experienced in proper positioning techniques.

 

Due to a shortage of staff during the pandemic, facilities may struggle to maintain high-quality care for residents. If regular bathing, skin evaluation, or regular repositioning is compromised, infection risk is increased. Additionally, if patients suffer from diabetic neuropathy, they may not be aware of injury to their feet and fail to alert care providers of the need for treatment.

Preventing Wounds From Becoming an Amputation

To avoid situations that could lead to amputation, long-term care facilities must train their staff on practices that help prevent the development and infection of wounds. Healthcare professionals need to stay up to date on how to care for patients who are suffering from skin ulcers and what the risks are.

Wound care is essential in all patients, but special consideration should be taken for patients with diabetes, who are more prone to ulcers. By properly training staff to recognize symptoms of impending problems, amputation could be avoided. Utilizing a risk score can help healthcare professionals predict and avoid serious situations from arising. 

 

The need to follow federal guidelines for health and safety are more important than ever in this time of pandemic crisis and in monitoring wound care to prevent amputation.