HospitalInspections.org

Based on record review and interview, the hospital failed to ensure each patient's right to visitation was provided according to hospital policy. The deficient practice is evidenced by the removal of a parent from the hospital in 1 (#3) of 3 (#1-#3) reviewed medical records.
Findings:

Review of policy number ADM-57, "Visitation," last review/revision 11/26/2022, revealed in part, "2. Visitation will be restricted if visitors engage in disruptive, threatening, or violent behavior of any kind as this behavior may interfere with the care of the patient and/or other patients or creates and unsafe environment for patients, families, and employees. . . . 5. Parents, legal guardians, or persons designated by the parent or courts may be with the patient 24 hours a day. . . . "

Review of the incident report involving the parents of Patient #3 dated 09/16/2023 revealed the following:

PM RN entered room to begin care. Parents expressed concern about RN health. RN attempted to alieve family's concerns by explaining she had allergies and had been assessed and assured by a provider that she was not contagious. Parents refused to have RN care for the patient and demanded another assignment. Due to acuity distribution on the unit at this time, the team was unable to accommodate the request. The parents asked to speak to the Nursing Supervisor and an Administrator, while continuing to refuse care from the assigned and available nurse. Eventually, the parents agreed to care by that nurse, while requesting that medications and labs be performed by the charge nurse. Their requests were accommodated as fully and promptly as possible while ensuring the care and safety of other patients on the unit.

In interview on 09/24/2024 between 2:42 p.m. and 2:59 p.m., S1CQO and S5RN explained that he mother had been "denigrating to the nurses both new and seasoned." The mother was known to scream and curse at the nurses frequently during their stay, creating a hostile work environment. The mother frequently requested that certain nurses not care for her daughter. The nursing assignments were based on acuity and the hospital is not obliged to reassign a nurse because the family does not like the nurse. The facility did routinely try to pair patients with nurses they have an affinity for, but it is not always possible.

In interview on 09/24/2024 at 3:00 p.m., S3DPSQ verified there were several high acuity patients including a patient with an unstable cardiac condition and another patient who was continuously seizing and the charge nurse was limited in her ability to help these patients because the family of Patient #3 wanted her to provide care to their daughter.

Review of the security report dated 09/17/2023, revealed the following:

DISTURBANCE
On Sunday 09/17/2023, S8SO, S7RN, and S4RN went to the sixth floor Pediatric Intensive Care Unit PICU) bed "a" to speak with the patents of Patient #3. S4RN informed the parents [mother and father named] that their disruptive behavior and verbal abuse towards the staff could not continue because it interfered with patient care for their daughter and other patients in the PICU. S4RN told the parents that they needed to take a break from their child's bedside. The offer was for one of the parents to leave the hospital from 3pm to 5pm while the other parent remains at bedside. Then switch from 5pm to 7pm. Both parents continued to complain but agreed. S4RN informed both parents that she would meet with them in the morning to discuss things further."

In interview on 09/25/2024 at 10:45 a.m., S4RN verified the mother was escorted out of the hospital and that the decision of which parent would leave first was left to the parent's decision. S4RN also verified her request for the family to "take a break" was not optional, and was based on the disruption caused during the evening shift on 09/16/2024. S4RN verified there was no specific incident where the parents were disruptive on 09/17/2024 that prompted their removal.

In interview on 09/25/2024 at 11:00 a.m., S3RN and S4RN verified the presence of the parents of Patient #3 made things difficult and the staff felt threatened on a daily basis, but there was no particular incident on 09/17/2024. S3RN and S4RN verified if the parents had been asked to leave while they were disruptive on 09/16/2024 or if there had been an incident on 09/17/2024, it would have been in accordance with the hospital policy.