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Based on observation, interview and record review the facility failed to provide an organized nursing services when,

-The patients in rooms 323 and 312 each had (3) IV (Intravenous) tubes with antibiotics and saline solution that did not have labeling identifying when the tubing had been initially hung, placing them at an increased risk for infection.

-The patients in rooms 312, 321 and 305 had peripheral catheter IV access sites that were not label or dated identifying when the peripheral catheter had been placed, placing them at an increased risk for infection.

- A former patient had a peripheral catheter that remained in the right foot for over 14 days, placing her at an increased risk for infection.

Findings Include:

Observations on the facility's in-patient unit on 10/31/17 at 12:40 p.m. revealed,
-Patient #7 and Patient #4 each had (3) IV tubes with antibiotics and saline solution that did not have labeling identifying when the tubing had been initially hung.
-The Patients #7, #6, and #2 each had peripheral IV catheter access sites that were not label or dated and did not indicate when and who had placed the IV's.

During a tour of the facility's in-patient nursing unit, on the afternoon of 10/31/17, Staff #2, Director of Nursing confirmed the findings.

Review of Patient #1's Nurses Notes dated 5/18/17 at 10:35 p.m. reflected, "Pt had pulled out IV ...Succesful [sic] IV to ...foot 24g. Further review of the Nurse's Notes from 5/18 to 6/1/17 reflected the IV catheter remained in the patient's right foot for over 14 days and was finally removed on 6/1/17 at 2:00 p.m.

During an interview on 10/31/17, in a facility office, Staff #2, Director of Nursing confirmed the findings. When asked for a copy of the facility's IV tubing and peripheral IV access site labeling policy, Staff #2 stated, "We don't have a policy for labeling IV sites ...IV tubing ...We use the Lippincott manual." Staff #2 paged through the Lippincott manual and did not find information covering the dating of the IV insertions or tubing. When asked what the nurses have been instructed on the labeling of IV insertion sites and tubing, Staff #2 stated, "I guess if we don't have a policy. We need to write a policy."

During an interview on the afternoon of 10/31/17, in the Facility Infection Control Office, Staff #9, Infection Control Officer stated, " ...we do weekly rounds ...we go department by department, looking at environment of care ...the only patient monitoring I do, is look to see if the central lines, PICC lines are changed ...I don't look at the IV tubing."

During an interview on the afternoon of 10/31/17, on the facility's nursing unit, Staff #6, Registered Nurse stated, "We used to place stickers on the IV tubing, we don't anymore we change all the tubing on Sundays and Thursdays." When asked how would they know if they had been changed Staff #6 stated, "We wouldn't know ...we don't document in the chart when the tubing is changed ...."