Tod, what excellent points! Gosh, want to come over and visit? We could use you at the hospital :-) I read your email to his mom (she does not have computer access at the moment). She told me at the LTAC, they took photos of his wounds and showed the family progress. At this acute care hospital, they do not do this. His wounds had progressed while under their care. Friday, I understood it took four- to five hours AFTER he was wet (BM) to change him. They claimed they did not have staff, change of shifts, other emergencies, etc. They also claimed he was not a candidate for the boots to keep his heels off the bed, because one of his legs turns out, and they don't want it to straighten his leg.. (or something like this). I believe the reason they are not doing this is because it is too much work or cost. Photos of the wounds will be very helpful. Thanks for the reminder! You suggested being polite to staff. I read this over the phone to his mother.. She laughed - It is a good suggestion but certainly not being followed all the time. There has been so great profanity and racial comments springing up during wound changes and turning. They have written everywhere he is refusing care and help rejecting- he is a behavior problem. This has prevented him from getting into or staying in other care facilities. But, he has a point, just not advocating for himself well. Having him laying in his own body waste for hours, is not acceptable. They are an acute care hospital, and do not seem to have trained staff. They did at least try by getting the patient advocate to go to the room. The mother told her to leave because she already had an advocate- me. I have had to communicate the hospital advocate will be able to do more internally than I can, and for her to use what resources she is given, as inadequate and incompetent as they may be. We cannot go around- we have to go through. Thanks Tod BestMed ---------------------Tod writes: If your friend believes as you do --that the wounds are being caused by, or worsened by, the care being given (or neglected) at any particular hospital, it would be a wise idea to have a close family member or friend available to photograph wounds as they are cleaned (hopefully!!) when dressings are changed. Many hospitals currently use digital photos as part of their records when it comes to wound healing but if this hospital does not, your friend can insist they allow a friend or family member to photograph them.
One simple and immediate benefit of digital photos of wounds is that your friend gets a chance to participate in his own care in that he will be able to see the wounds for himself much better... from the point of view of the nurse, doc or other caregiver. Also, dated photographs of wounds that happen to continually be getting worse throughout the course of care by an institution can do two things: 1) they can be added to official medical records to show whether records acurrately reflect wound size and severity while under an institution's care, and 2) the act of photographing wounds can influence the quality of care the wounds receive! If nurses know additional records are being kept by the patient they are more likely to provide more careful care (not that they purposely get careless... it just happens). He should carefully watch everyone involved in touching the wounds and be certain they wash their hands before touching him and wearing clean gloves every time they touch the wound!! (This includes NOT reaching into a pocket for tape or a pen with a gloved hand and then continuing to use that glove on the wound. After all, what else has been in that pocket? Where else was that pen or tape used?) But along with all that... in fact ABOVE ALL that... he should be sure to be friendly and polite while self-advocating for his care. If he seems to be combative it could be interpreted as refusing care. If refusing certain care is anywhere in his notes, the fault for any problems related to it will fall on him. Best of luck again for your friend! Best regards, --Tod (been there, done that!) ---- medethics Cvlrights <[email protected]> wrote: > I found the answer to my question. At the hospital, they can use a Flexi-Seal system to keep feces away from wounds. This is used instead of invasive surgery such as colostomy. > http://www.convatec.com/en/cvtus-oursltnfus/cvt-portallev1/0/detail/0/1602/1947/our-solution-flexi-seal-fms.html > I also found this link interesting. Stage IV ulcers could have led to my > friends sepsis while in the acute care hospital and can lead to bone > infections. > http://www.convatec.com/en/cvtusfecmngprus/cvt-prtprogdet/0/detail/0/1600/2572/pressure-ulcer-prevention.html > On the page, I read Medicare no longer pays the hospital for treatment of > patients new pressure sores caused by the hospital during their "care". Now I > am starting to understand why they wish to ship my friend out so quickly- he > received new stage IV wounds at the hospital but it appears they may not be > reimbursed because it was preventable. Also, this may explain why the other > acute care hospital is giving us a difficult time to push for a doctor to > doctor- (hospital to hospital) transfer. Very interesting, but I don't know > the solution other than hoping his current hospital will take better care of > his wounds so they will heal.
