Alice Brown is 72 years old and lives alone in a bungalow since her husband passed away 2 years ago. Both her daughters have their own homes and families, but Caroline tries to visit her mom at least a couple of times a week.
Alice is visited on alternate days by the Community nursing service to have her venous leg ulcer dressed. On her last visit, it was noted that Alice had been incontinent of urine, and her urine had an offensive odour. The community nurse was also concerned that Alice appeared to be newly confused. Following discussion with her GP, Alice was admitted to Acute Medical Unit (AMU).
On the ward, the wound dressing is removed, and it is noted that there is urine and wound exudate on the bandaging. The wound is red and inflamed. Alice’s heart rate is 112 and her blood pressure is 98/62mmHg. Her respiratory rate is 24 breaths per minute with saturations of 92% on room air. She is responding to voice. She weighs 70kg and her temperature is 39.6. Her BM is 6.2mmols, and she has passed 20mls of urine in the last hour. Alice has a pain score of 6 out of 10.

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