HospitalInspections.org

Based on a review of 5 clinical records and an interview of two St. Charles Medical Center - Bend Home Health and WOCN administrators, it was determined that in 1 of 5 records, Record # 5, nursing care was assigned to a registered and WOCN certified nurse but that registered nurse performed patient care activities that were not delineated in the hospital's written policies and procedures. Findings are:

Based on the review of patient record # 5 during a clinic appointment at 08:58 on 12/30/2011, documentation of the visit note stated: "Wound intervention: Calcium alginate, cleaned, debrided, hydrocolloid, paste. Cleansed well with optipore and shurclens, rinsed with NS (normal saline), attempted to debride some soft necrotic tissue with forceps, very painful."

When asked, on 03/06/2012 at approximately 3:30 and again on the morning of 3/7/2012 at approximately 08:00, to provide and policies and procedures related to instrument wound debridement, interviewees B & C stated that they could not produce a policy and procedure, protocol, or additional evidence that WOCN staff could perform instrument debridement.