HospitalInspections.org
Bringing transparency to federal inspections
PERIMETER BEHAVIORAL HOSPITAL OF DALLAS
ORGANIZATION OF NURSING SERVICES
Tag No.: A0386
Based on record review and interview the facility failed to have a well-organized service in that 1 of 5 (Patient #2) diabetic patients were admitted to the facility with an insulin pump. The facility failed to have nursing policies and training regarding the use of insulin pumps.
Findings included:
Patient #2 a 16-year-old Type 1 diabetic was admitted to the facility on 06/26/24. Patient #2 was wearing an insulin pump and a continuous glucose monitor.
During an interview on 07/09/24 at 10:30 AM Personnel #1 stated the facility did not have any policies regarding patients with insulin pumps and continuous glucose monitoring systems.
RN SUPERVISION OF NURSING CARE
Tag No.: A0395
Based on record review and interview the nurses failed to evaluate the care of 3 of 6 (Patient #2, #6 and #10) diabetic patients.
Findings included:
Patient #2 was admitted to the facility on 06/26/24 with a history of Type 1 Diabetes. The Physician's Orders dated 07/02/24 reflected Sliding Scale Insulin Protocol...If patient has a single blood glucose > 400 mg/dl-notify physician..."
The Diabetic Clinical Record reflected...07/03/24 06:00 AM Glucoscan Bloodsugar...525..." The Shift Progress Note for 07/03/24 does not reflect the physician was notified of the patient's blood glucose level.
Patient #6 was admitted to the facility on 04/03/24 with a history of Diabetes. The Physician's orders dated 04/03/24 at 12:31 AM reflected..."Fingerstick blood glucose qAC (before meals), every bedtime..."
The Diabetic Clinical Record does not reflect a Fingerstick blood glucose being performed on 04/05/24 before breakfast and at bedtime; on 04/06/24 at bedtime; on 04/07/24 before breakfast; on 04/10/24 before breakfast and at bedtime; on 04/11/24 before breakfast and at bedtime; on 04/12/24 before lunch; on 04/13/24 before breakfast; on 04/14/24 before breakfast and before dinner.
Patient #10 was admitted on 06/29/24 with a history of diabetes. The Physician's orders dated 06/29/24 at 06:11 PM reflected..."Fingerstick blood glucose qAC (before meals), every bedtime..."
The Diabetic Clinical Record does not reflect a Fingerstick blood glucose being performed on 06/30/24 at bedtime, and on 07/04/24 there was not a documented blood glucose before breakfast, lunch or dinner.
During an interview on 07/10/24 at 01:35 PM Personnel #1 verified the above findings.