HospitalInspections.org

Based on review of documents and staff interview, it was determined the facility failed to ensure each individual presenting to the Emergency Department (ED) seeking assistance was entered into the central log in one (1) of one (1) patients (#1 on identifier list) who presented to the ED. This has the potential to negatively affect all patient's by preventing them from being registered as a patient in the ED.

Findings include:

1. Review of the ED log, date 9/27/11, revealed patient #1 had not been entered into the log upon presentation to the ED for the second visit.

2. Review of the complaint file from the facility revealed two (2) Registered Nurses (RN's) were aware of the patient's return to the ED on 9/27/11 and failed to place the patient's name in the ED log. They encouraged the patient to leave the facility and call an ambulance to transport him to another facility.

3. During an interview with the Clinical Nurse Manager in the afternoon of 11/7/11 and the morning of 11/8/11, she revealed the staff did not enter the patient's name into the ED log.

4. During an interview in the morning of 11/9/11 with the two (2) RN's who cared for the patient on 9/27/11, they revealed when the patient returned to the ED later in the evening, they encouraged the family to call 911 and have the patient transported to another facility. They also stated they did not notify the physician the patient had returned.

Based on review of documents, medical records and staff interview, it was determined the facility failed to ensure a medical screening exam (MSE) is provided for every patient presenting to the Emergency Department (ED) in one (1) of one (1) medical records reviewed for a MSE (Patient #1). This has the potential to negatively affect all patient's by not ensuring a MSE is conducted to rule out a medical emergency.

Findings include:

1. Review of the hospital complaint file for patient #1 revealed two (2) Registered Nurses (RN's) spoke with the patient on his return to the ED on 9/27/11 and encouraged the patient to go to another facility for specialized help. The RN's both encouraged the patient's family to go to their car and call 911 if they did not feel comfortable transporting the patient themselves.

2. An interview was conducted in the afternoon of 11/8/11 with the physician on duty 9/27/11 and he revealed he was unaware the patient had returned to the ED.

3. During an interview conducted in the morning of 11/9/11 with the two (2) Registered Nurses (RN #1 and RN #2), they revealed they both went to the waiting room to talk with the patient and his son and encouraged the son to call 911 and have the patient transported to another facility for care.