Pts. transferring from the hospital to TCU

[SunnyAndrsn]

I have a question for nurses in hospitals, I mean no disrespect, but this is the third time we've taken an admit to our TCU in recent weeks with this issue...

Three pts discharged from three different area hospitals, all with various skin tears or head lacerations...no stiches, but poorly cared for wounds. In one case, the bandage was dated the day of the hospital admission--no one looked at that wound (several inches long, edges poorly approximated, and I had to soak off the bandage because it was caked with blood and stuck to the wound).

Head laceration: Caked with blood, unable to determine the size of the actual wound. If I had to judge by the size of the dried blood, I would have measured this wound at 8cm long. It was about 1cm long, after pt had been cleaned up.

Pressure sore that had started at home, ended up being debrided at our facility and needed a wound vac. Aren't there wound care teams to look at these things? Pt. with extreme edema, no ted hose or ACE wraps...why aren't nurses asking for these things while the pt. is in the hospital?

Also, poor oral hygiene on these pts, one A&O, but unable to brush without assistance, was a former nurse, asking for help, not getting it.

All three were injured d/t falls, came to us after approximately 4 day stays in the hospital. In four days, is there really no time to have someone clean the pts up? How do you document on wounds when no one is looking at them? When no one is cleaning up the blood how do you check for s/s of infection in the wounds? Or document the size?

It takes us 10-15 minutes of TLC with mouth cares, lip balm, and washing off the dried up blood can make someone feel 100x better. What's the deal that during a four day stay no one does this stuff?

Are we just having bad luck with these admissions? Please tell me this is not the norm!

[NurseyPoo7]

I would say bad luck, but my hospital has no wound care team and we are required to document on all wounds on the admission assessment, including measurements. Sometimes if a patient is a hard turn, it can be hard for me to find someone to help me.