HospitalInspections.org

Based on record review and interview, the hospital failed to ensure the prevention of workplace violence against patients for one (Patient #3) of nine patients.

Findings:

Patient #3

Review of an internal document dated 11/30/24 read in part, "witnessed the bedside nurse put a pillow over the patient face and held it there for about 10 seconds to stop the patient from yelling."

Review of body worn camera footage "2024-11-30 0413 D01B01411" at approximately the 17:47 minute mark, showed Staff P stated, "all I was trying to do was just threaten her to be ...quiet."

Review of an internal document dated 12/03/24 showed Staff P was terminated from employment.

On 12/12/24 at approximately 2:32 PM, Staff D stated Staff P was terminated for an act of violence toward a patient.

Based on record review and interview, the hospital failed to ensure a nursing care plan specific to the patient's needs for one (Patient #9) of nine patients.

Findings:

Patient #9

Review of a policy titled "Patient Plan of Care" read in part, "The plan of care should be individualized to address specific patient/family needs."

Review of a history and physical dated 10/30/24 showed the patient with possible pneumonia and acute respiratory failure.

Review of the nursing care plan for 10/30/24 through 11/04/24 showed no problem to reflect ineffective breathing pattern or its resolution.

On 12/13/24 at 12:28 PM, Staff J stated there should have been a respiratory problem included on the care plan.