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ST VINCENT HOSPITAL
PATIENT RIGHTS: CARE IN SAFE SETTING
Tag No.: A0144
Based on interviews and medical record review, the hospital failed (for 1 of 17 patients sampled, Patient #15) to provide care in a safe setting. The hospital failed to have a sufficient number of cardiac telemetry boxes (also known as teleboxes, a portable device placed on the patient designed for continuous monitoring of a patient's ECG (electrocardiogram, which records electrical signals from the heart), respiratory rate, oxygen saturations) to appropriately monitor patients who have active orders for cardiac telemetry monitoring.
Findings include:
The administrative/clinical policy titled "SVH ADM CLN 8.6.8 Cardiac Monitoring - Inpatient Critical and Acute Care," last reviewed 04/08/2021, states under the implementation section, "Cardiac monitoring is available on selected patient care units throughout the hospital by physician/provider order."
The surveyor interviewed Nurse #6 on 02/05/2024 at 2:30 P.M. Nurse #6 stated that there is supposed to be a telebox readily available for every patient and/or bed on the unit.
The surveyor interviewed Nurse #7 on 02/05/2024 at 2:45 P.M. Nurse #7 stated that there is typically not enough teleboxes available on this telemetry unit. Nurse #7 stated that the situation comes up often where a patient arrives to the telemetry unit with telemetry orders and the nurse has to either wait for an available telebox or "go hunting" for a telebox.
The surveyor interviewed the Chief Nursing Officer (CNO) on 02/05/2024 at 3:15 P.M. The CNO stated that the expectation is that when a patient who is on telemetry orders arrives to the telemetry unit, that the patient is immediately provided a telebox so that cardiac monitoring can be initiated and/or continued in a prompt manner.
Medical record review on 02/07/2024 indicated that Patient #15 had an active order for cardiac telemetry dated 02/04/2024 at 8:17 P.M. This order was set to be active for 72 hours.
The surveyor interviewed Nurse #6 again on 02/05/2024 at 3:30 P.M. Nurse #6 stated that Patient #15 had arrived to the telemetry unit on 02/05/2024 at 3:00 P.M. with an active telemetry order. Nurse #6 stated that Nurse #6 received the telemetry box device on 02/05/2024 at 3:27 P.M., a 27 minute delay from when Patient #15 arrived to the telemetry unit.