The Impact of Covid-19 on Pressure Sore Mitigation and Prevention

It is now a little more than two years since the Covid-19 pandemic was declared by the World Health Organisation. Vaccination and new drugs have reduced the effects of the virus and relieved stress on the NHS and residential care homes where some of the more serious outcomes of Covid-19 were (and still are) experienced. In the early stages of the pandemic, and during each successive wave as new variants developed and spread, it wasn’t just illness and deaths from contracting the virus itself that was the problem. It was the pressure on non-Covid health care, which contributed to poor health outcomes.

Wound care, including treatment of pressure sores, accounts for about 50% of the workload of community nursing for example, so any reduction in nursing time because of the effects of a major illness like Covid-19 can have significant effects on the ability to monitor and treat sores. A typical example of what was happening at the beginning of the pandemic is described below.

Case study: 62 year old develops pressure sores due to negligence in hospital care

Most avoidable pressure sores have occurred in either hospital wards or residential care homes where patients or residents respectively have not been attended to sufficiently to prevent pressure sore development. Even relatively healthy people can develop pressure sores while in hospital if the standard of care is not sufficient. Martyn Cope, a 62 year old Druids Heath resident, was admitted to Queen Elizabeth Hospital on April 11^th 2020 at the start of the Covid pandemic when the NHS was becoming under increasing stress.

Mr. Cope was not experiencing Covid symptoms, but was diagnosed with a septic knee. He was admitted to the orthopaedic ward at the hospital where he developed pressure sores on his heels, despite there being no obvious problem with his heels on admission. He was discharged from hospital after two weeks. His pressure sores subsequently became so serious that he found it very difficult to move around despite getting constant support from his wife who helped to change his dressings regularly.

Mr. Cope did consider legal action against University Hospitals Birmingham NHS Foundation Trust after an investigation revealed that his pressure sores were preventable. Mr. Cope apparently had been assessed as having a Waterlow score of 20, which meant that he had a much higher chance of developing pressure sores without appropriate care and intervention. He did receive an apology from the trust, which admitted that a proper assessment had not been made, daily inspections of his skin and appropriate repositioning had not been made and an air mattress, which could have helped to avoid pressure sores developing, had not been supplied until too late. In this case, Mr. Cope decided not to pursue legal action after receiving the apology.

Cases of negligence still occur despite relief from the pandemic

The pandemic is not over, despite restrictions having been mostly removed. New variants may still evolve and vaccines are not yet perfect foils to the virus. The NHS and residential care homes are still under stress despite the drop in Covid cases. This should not be an excuse to allow pressure sores, however, in any care environment. The reasons why pressure sores develop are well known. Prevention is not only better for patients and residents, but in the long run is cheaper and less time consuming than having to deal with severe sores and related illness, including sepsis and possible death.

If you have a loved one being cared for in a hospital or residential facility, you should be able to expect that your relative is being cared for appropriately. You have the right to take legal action against any facility which has been found to have acted negligently.