My dad was admitted to a nursing home in June of this year. Recently, he suffered what seemed to be a small stroke, with some impairment of movement on his left side. After this, he began to have trouble with bedsores, as he was not moving himself around enough in the wheelchair to relieve pressure. The nursing home tried different strategies to relieve the pressure, but finally had to put him on bedrest for about a week.
Last Wednesday, I visited, and he was up in his chair for the first time in over a week. They had a new, very expensive cushion for him, and I though everything was going to be okay. Unfortunately, it was not to be. By the time they put him back to bed, his left buttock had a hard swelling about 6 cm. in diameter. It got worse as the week went on, and by Saturday he was running a fever. They sent him to hospital, where they opened and debrided what was now a nasty abcess.
Unfortunately, I had to work on the weekend, so I didn't get to see the wound until today. He's got a stage 4 ulcer, necrotic around the edges, and a little larger than a golf ball, with dark, very foul smelling drainage (fecal odour). Very nasty looking!! They are changing the dressing BID and packing it with Betadine soaked gauze.
Now, here comes the shocker. While I was there tonight, the nurse came in to do the dressing change. She was not wearing sterile gloves. She cleaned the wound with non-sterile 4x4's (no forceps, just held the gauze in her fingers) She then took a length of ribbon gauze that was sitting in a bottle which did not have a lid on it, put it in a non-sterile med cup, and poured betadine on it. She then used her (non-sterile) gloved fingers to pack it into the wound!!
I have requested that a wound-ostomy resource nurse go in and assess the wound, and its treatment. (I also plan to be there myself, if at all possible!) Hopefully, she will teach them a thing or two about proper wound care technique!!
My question for my fellow nurses is: How common is it for nursing homes to have such horrible standards for wound care? I can't blame the nurse...she was from an agency, and obviously knew better, because she actually apologized to me, and said, "This is all they have given me to work with!"
