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Nappy rash / pressure sore? - Carers UK Forum

Nappy rash / pressure sore?

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Lack of staff, lack of attention, lack of adequate continence care has resulted in Dad suffering a large ‘welt’ between his buttocks. Obviously I shouldn’t have seen this but because I end up doing most of his care I have. I drew their attention to it and they said they’d find a ‘lolly pop stick’ which is apparently some kind of barrier cream. Except that nobody could find any, not even on the other wards. I couldn’t check yesterday but I had another look today because Dad was complaining about it again and it is now leaving a corresponding patch on his pad. I again drew it to their attention and they again told me there was no barrier cream in the hospital. I asked if it should be dressed and they said no, it needs to be checked on and that can’t be done if it’s dressed. Bearing in mind he has a chest infection, an ear infection & he is trying to get out of hospital, I’d really like to avoid another infection and I think they should be doing something more than applying emollient to it. It’s a wet wound and it’s frequently exposed to urine and sometimes faeces. It’s not going to heal using a product that’s going to make it more moist is it? Any ideas what they SHOULD be doing?
Henrys Cat wrote:
Sat Jul 16, 2022 11:19 pm
Lack of staff, lack of attention, lack of adequate continence care has resulted in Dad suffering a large ‘welt’ between his buttocks. Obviously I shouldn’t have seen this but because I end up doing most of his care I have. I drew their attention to it and they said they’d find a ‘lolly pop stick’ which is apparently some kind of barrier cream. Except that nobody could find any, not even on the other wards. I couldn’t check yesterday but I had another look today because Dad was complaining about it again and it is now leaving a corresponding patch on his pad. I again drew it to their attention and they again told me there was no barrier cream in the hospital. I asked if it should be dressed and they said no, it needs to be checked on and that can’t be done if it’s dressed. Bearing in mind he has a chest infection, an ear infection & he is trying to get out of hospital, I’d really like to avoid another infection and I think they should be doing something more than applying emollient to it. It’s a wet wound and it’s frequently exposed to urine and sometimes faeces. It’s not going to heal using a product that’s going to make it more moist is it? Any ideas what they SHOULD be doing?
Hugs. Perhaps try gentle threats.
In a way, Thara's suggestion is appropriate...ask to speak to the skin integrity nurse at the hospital (not all hospitals have one, but quite a few do), and failing that ask to speak to the hospital's safeguarding team. Pressure sores at that level are a sign of neglect. Make sure you also notify your MP...
The MP for the hospital area is Penny Mordaunt…

I’m right though aren’t I? It won’t heal with an emollient?
As far as I know, emollients aren't used for pressure sores, but I have no direct experience. This link is really useful as it's the NHS take on treating pressure sores. I think it backs you up. https://www.nhs.uk/conditions/pressure-sores/treatment/
Henry's Cat,

your poor Dad.

Pressure sores are reportable to the CQC once they get to a certain severity and hospitals are supposed to have systems in place to prevent them. Clearly this isn't happening due to all sorts of reasons.

If he needs a lolly pop stick I think they mean a Debrisoft Lolly, and there are non in the whole hospital ... then the ward doctor or prescribing nurse should be requesting them from the hospital pharmacy or whoever is responsible for ordering them if they are not patient specific.

If the hospital don't have a skin integrity nurse, I think I would contact PALS or someone higher up in the hospital.

Sending cyber support.

Melly1
Thanks both. I asked again about a barrier cream and was again told there was none in the hospital. I said I’d probably try and get hold of the skin integrity team to see what they advised instead as I’d managed to find out they had a department for this on the website. They don’t work weekends of course. The nurse went off to see what his prescription was for this apparently - I’d be very surprised if there was any such thing.

I started to do my usual ‘move him up the bed’ thing, as I try and get there in time for a meal so need him to bending in the right place for the bed. This was much to the alarm of the HCA & nurse in the room who I hadn’t met before! I asked to have a look at his wound (not really sure if it counts as a pressure sore or not because it’s not from pressure, just from urine contact). She said it was drying it, it clearly wasn’t & it was worse - bigger and weepier, and Dad was begging them to put something on it because it was so sore. She went off to find something to put on it and low and behold came back with 3 packets of the special barrier cream! I can’t recall what it was called but I’ll make sure I make a note tomorrow. Apparently there are shortages with various things like this across the hospital but she couldn’t say if it was a nationwide thing or not.

I don’t know what they mean by a lollipop stick as I just looked up the debris off it the wound doesn’t look like it needs debriding etc, just covering to protect it from more urine. They said it was something to do with evaporation & trapping moisture. Hopefully this stuff will do the trick anyway. Thanks so much for your advice!
Is it Cavilon?
Yes agree with Greta. Could it be Cavilon? My medically non compliant husband has those daily. They are very good and his sores are much better - almost healed although skin very delicate in places. I would be amazed if a hospital has none of these. The District Nurses usually carry a supply. Good luck.
I never managed to find out because between leaving at 7 Saturday night and arriving back at 12 noon on Sunday, all the sachets had gone. We were there for 6 hours yesterday and they never applied anything despite us asking several times. I spoke to the consultant in the end because it's causing Dad a lot of pain and he again said he would make sure something had been prescribed. I also asked the HCA if it had been put on Datix and she said she 'thought so'. I'm hoping that mentioning that, like mentioning the skin integrity team, it will let them know that I know more than they think I do! It looked to have slightly healed around the outside and the HCA said it wasn't weeping but it was wet enough to stick to the pad and leave a darker mark than before. I'll try again today...