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Based on observations and interviews, the facility failed to ensure patients in the Emergency Department had consistent access to the nurse call light.

This failure created the potential for the patient's medical needs to not be addressed.

FINDINGS

1. The facility failed to ensure the nursing staff made the call light available to the patients in the Emergency Department.

a) Observation of call lights not placed with patients in the Emergency Department (ED) revealed, on 03/06/17 at 11:20 a.m., Patient #4 was observed in Exam Room #7 laying on a bed without a call light within reach. An interview was conducted with Patient #4 who reported that a nurse did not offer him/hear call light. Patient #4 reported s/he was not instructed on how to get in touch with a nurse if the nurse was needed. Patient #4 also reported s/he was cold and would have liked to have a warm blanket but had no way of asking for the blanket. The call light was observed hanging on the wall behind the patient which was out of reach of the patient and not within view.

On 03/06/17 at 11:30 a.m., a patient was observed laying in a bed without access to a call light. The patient had a family member with them. The call light was observed hanging on the wall. The family member reported that no one gave them instructions on the use of the call light. The family member reported s/he knew they could push the button on the call light for help while it was hanging on the wall. The family member reported s/he would not know how the patient could get help if they left the patients side.

On 03/07/17 at 8:32 a.m., a patient was observed in Exam Room #20 laying in a bed without a call light within reach. The call light was observed hanging on the wall behind the patient's bed which was out of the patient's reach and not within the patient's view.

b) On 03/07/17 at 2:14 p.m., an interviewed was conducted with Registered Nurse #11 (RN) who reported the expectation was the call light would be placed at the bedside in the ED room.

c) On 03/08/17 at 8:13 a.m., an interview was conducted with the ED Nurse Director (Director #1) who reported that the nurse was to instruct the patient how to use the call light. S/he stated the risk to a patient without access to a call light was the patient could be at risk for a fall and if the patient had chest pain or could not breathe they could not make their needs known.