HospitalInspections.org

Based on observation and interview the facility failed to provide privacy for patients when:
- the patient's last name was visible to the public on erase boards in four of the units observed
- video monitoring equipment was used in the Emergency Department without informing patients and visitors
-one patient was observed to be uncovered from under the breasts to the pubis
The facility census was 263.

Findings included:

Observation on 4/20/10 at 9:40 a.m. revealed Patient #1 with the sheet pulled down to his/her pubis and his/her gown tucked under his/her breast with the abdomen exposed to all who walked by the room.

Observation on 4/20/2010 at 9:40 a.m. reveals surveillance cameras located in the Emergency Department waiting room and within the Emergency Department hallways. There are no signs located in these areas informing patients they are being monitored.

Interview on 4/20/2010 at 9:40 a.m., Staff Q, Registered Nurse, Assistant Manager of the Emergency Department stated there was no signs posted informing patients they were being monitored by cameras.

Observation on 4 West, 4 East, CICU (Cardiac Intensive Care Unit and BICU (Burn Intensive Care Unit) revealed an erase board behind the nursing stations approximately two feet by four feet with the patient's full last names written on it. The board was in full view of patients or visitors who would walk by and did not protect their privacy and confidentiality.

Based on observation and interview, the facility failed to ensure staff monitor and track drugs used in the Sexual Assault Nurse Examiner (SANE) clinic. These drugs are Emergency Contraceptives, antibiotics, and non-narcotic pain medication. The facility census was 263.
Findings included:
Observation on 4/20/10 at 1:03 p.m. revealed medications in the Sexual Assault Nurse Examiner (SANE) clinic are not inventoried or monitored on a regular bases.
During an interview on 4/20/10 at 1:03 p.m. Staff Q, Registered Nurse, Assistant Manager of Emergency Services revealed the medication is ordered when needed and no inventory log is kept for receiving the medication. He/she stated the only documentation of dispensing these medications is in the patient's medical chart.

Based on observation, record review and interview the facility failed to ensure all drugs were secure on one unit. This had the potential to affect all patients.
-one unit had a crash cart whose breakaway tag was not intact and was sitting in the hallway
-a box containing drugs was sitting in the crash cart . The facility census was 263.

Findings included:

-Observation on 4/20/10 at 9:40 a.m. reveals an unlocked patient treatment cart (a cart where dressings, bandages, and supplies are stored) inside a patient room which contains three bottles of nitroglycerin spray (a medication used in the treatment of chest pain) in the top drawer.
-An interview on 4/20/10 at 9:40 a.m. Staff Q, Registered Nurse, Assistant Manager of Emergency Services states the medication should not be stored in the cart.
-Observation on 4/20/10 at 10:10 a.m. of the medication area, which is not secured and is located next to the main ED hallway, shows one nitroglycerine spray bottle in an unlocked cabinet.
-An interview on 4/20/10 at 10:10 a.m., Staff Q, RN, states the medication should not be stored in the unlocked cabinet. The medication does not have an intact integrity seal, and there is no open date or time labeled on the medication.
-Observation on 4/20/10 at 10:10 a.m. of the ED crash cart (a cart which contains equipment used in an emergency) reveals Emergency medications in a box, on a shelf, on top of the crash cart. The box has an integrity seal which is intact. The box is not secured to the crash cart and there is no staff in the current area with direct visualization of the cart at this time other than surveyor and Staff R, RN, Staff Nurse, who is inspecting the crash cart together.
-Observation on 4/20/10 at 11:10 a.m. revealed a crash cart (a set of trays/drawers/shelves on wheels with medication/equipment used for emergency to save someone's life) sitting in the hall outside of the nursing station. The break away tag was not intact. A box (similar to a tackle box) containing drugs such as atropine, (a drug which may be used to increase heart rate), epinephrine (a drug used to increase heart rate, contract blood vessels and dilates air passages), sodium bicarbonate (a drug used to raise the pH) [a measure of the acidity or basicity] which also had a break away tag and was found placed in the bottom of the cart which was not locked.

-An interview on 4/20/10 at 11:15 a.m. with Nurse Manager G stated the cart was right outside the nursing station and someone would notice if the box with medications was missing.

-An interview on 4/20/10 at 1:45 p.m. with Chief Nursing Officer B stated he/she would not expect to see a drug box from a crash cart outside of the locked cart.

Based on observations and interviews, the facility failed to ensure staff remove outdated and expired supplies. Two of five patient care areas observed were found to contain expired supplies. The facility census was 263.
Findings included:
Observation on 4/20/10 at 9:40 a.m., revealed a patient treatment cart which contained one blood culture collection bottle, two vials of Sterile Water, two bottles of Normal Saline, and five blood collection vials, all of which were expired. The cart also contained several boxes of needles. The cart is located inside of the the patient's room labeled 18 a-b and is unlocked.
Interview on 4/20/10 at 9:40 a.m. Staff Q, Registered Nurse (RN), Assistant Manager of Emergency Services verified the supplies were expired and stated the needles should be kept in a locked cart.
Observation on 4/20/10 at 11:10 a.m. of patient treatment room labeled Exam 12 was found to contain two blood culture specimen collection bottles and two blood collection vials which were expired.
Interview on 4/20/10 at 11:10 a.m. Staff Q, RN, Assistant Manager of Emergency Services verifed the supplies were expired.