HospitalInspections.org

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Based on interview, policy and procedure review and medical record review it was determined the hospital failed to implement hospital policy regarding the investigation and reporting of alleged abuse in its resolution of a complaint from 1 of 5 sampled patients (Patient 5). Findings include:

During the survey a sample of five medical records of patients admitted to the hospital "3 Tower" unit during the week of 6/10/11 was selected for review. That review revealed that on the night of 6/10/11 Patient 5 experienced an incident he/she perceived to be "frightening" and "terrifying."

According to hospital records Patient 5 reported to Employee 7 that he/she had been "held down," "manhandled" and "threatened" by Employee 6. Patient 5 reported that the incident had occurred in the presence of Employee 8.

In interview on 8/23/11 at 12:30 pm Employee 8 stated that he/she had been present during the alleged incident. Employee 8 reported that he/she saw or heard no evidence of an incident of verbal or physical abuse by Employee 6. Employee 8 could not verify the description of events as perceived by Patient 5.

Record review and extensive interview with Employees 2, 3, 4, 5, 7 and 8 revealed no evidence to support the allegation of verbal and physical abuse by Employee 6. However, it was determined the hospital failed to implement the appropriate hospital policies and procedures regarding the identification, investigation and reporting of such alleged incidents.

Policy review revealed the hospital had a specific policies and procedures on how alleged incidents of abuse were to be processed. Those procedures were outlined in policies, "Patient Complaint/Grievance Procedure," "Patient Rights and Responsibilities," and "Abuse: Reporting Guidelines."

According to hospital policy "Patient Complaint/Grievance Procedure," all "complaints alleging abuse or neglect" will be considered a grievance. Under policy, the categorization of a complaint as a grievance initiates a specific procedure of documentation, investigation and reporting. The hospital failed to implement those procedures following Patient 5's complaint of abuse on 6/10/11.

In interview on 8/23/11 at 1:30 pm Employee 7 acknowledged that on the night of 6/10/11 Patient 5 had complained that Employee 6 had "held her down," "threatened" her, and "manhandled" her. Employee 7 further acknowledged that he/she had not initiated the hospital reporting mechanism for such allegations of abuse as required by policy.

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