Overlooked Pain Assessment Records in Patients with Pressure Injuries During the COVID-19 Pandemic: A Retrospective Data Analysis.

Adv Skin Wound Care

Tuba Sengul, PhD, RN, CWON, is Associate Professor, School of Nursing, Koç University, Istanbul, Turkey. Sevilay Erden, PhD, RN, is Associate Professor, Çukurova University, Adana, Turkey. Ayişe Karadağ, PhD, RN, ET/WOCN, is Dean and Professor, School of Nursing, Koç University. At Koç University Hospital, Dilek Yilmaz, MSc, RN, and Tugba Gokduman, RN, are Wound and Ostomy Care Nurses. Acknowledgments: The authors thank the nurses and institutions who took part in the study. The authors have disclosed no financial relationships related to this article. Submitted February 1, 2023; accepted in revised form April 26, 2023.

Published: March 2024

Background: During the COVID-19 pandemic, healthcare professionals focused on identifying the cause of hemodynamic instability in patients and may have neglected to assess pressure injury (PI)-related pain. Although pain is an early indicator of PI development, there has been no systematic evaluation of PI-related pain in patients.

Objective: To review nurses' records of PI-related pain in patients who developed PIs during the COVID-19 pandemic.

Methods: This retrospective, descriptive study included data from 510 patients at one hospital. Collected data included patient demographics (age, sex, diagnosis, and comorbidities), PI classification, and assessment of PI-related pain. Assessment data regarding PI-related pain included the characteristics of the pain, the type of analgesia (pharmacologic/nonpharmacologic) administered before and after PI management (debridement, dressing change, etc), the route of administration, and the frequency of pain assessment before and after analgesia.

Results: The mean age of the patients (60.4% men) was 28.96 (SD, 5.82) years, and the mean length of hospital stay was 26.15 (SD, 16.1) days. Overall, 43.1% of the patients were treated in the ICU, 68.0% were conscious, and 18.6% tested positive for COVID-19. Deep-tissue injuries occurred in 57.5% of patients, with 48.6% developing stage 2 PI. The sacral region was the most common area for PI development (44.8%). The mean duration of repositioning in patients with PI was 23.03 (SD, 5.4) hours. Only 0.40% of patients (n = 2) were evaluated for pain, and only one patient was assessed for pain before and after analgesia was administered.

Conclusions: The findings suggest a lack of comprehensive evaluation and records concerning PI-related pain in patients with COVID-19.

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http://dx.doi.org/10.1097/ASW.0000000000000105DOI Listing

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Overlooked Pain Assessment Records in Patients with Pressure Injuries During the COVID-19 Pandemic: A Retrospective Data Analysis.

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March 2024

Tuba Sengul, PhD, RN, CWON, is Associate Professor, School of Nursing, Koç University, Istanbul, Turkey. Sevilay Erden, PhD, RN, is Associate Professor, Çukurova University, Adana, Turkey. Ayişe Karadağ, PhD, RN, ET/WOCN, is Dean and Professor, School of Nursing, Koç University. At Koç University Hospital, Dilek Yilmaz, MSc, RN, and Tugba Gokduman, RN, are Wound and Ostomy Care Nurses. Acknowledgments: The authors thank the nurses and institutions who took part in the study. The authors have disclosed no financial relationships related to this article. Submitted February 1, 2023; accepted in revised form April 26, 2023.

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