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COVENANT MEDICAL CENTER
PATIENT RIGHTS
Tag No.: A0115
Based on interview and record review the facility failed to protect the rights of one (#1) of two patients reviewed for behaviors resulting in the potential for the risk for loss of their rights.
Findings include:
(See A-194) The facility failed to ensure Security staff I was trained in Crisis Prevention Intervention and Pressure Point Control Tactics.
PATIENT RIGHTS: RESTRAINT OR SECLUSION
Tag No.: A0194
Based on interview and record review, the facility failed to ensure one (security staff I) of three employees whose personnel files were reviewed were trained in the facility's protocol for deescalation techniques or Crisis Prevention Intervention (CPI), resulting in the less than optimal outcomes for patient #1. Finding include:
On 9/18/2020 at 1330 review of surveillance footage revealed patient #1 was prompted and escorted to his room two times by Security Staff I to return to his room on 9/5/2020 between the hours of 1950 and 1954. The patient was observed during those times going to and from his room as directed without incident.
On 9/5/2020 at 1955 Staff I was observed as he escorted the patient back to his room and closed the patient's door upon exiting. At that time, patient #1 was observed as he banged on the closed door and window and proceeded to shove a bedside tray that held a food tray into a wall while in his room. There was no audio sound with the footage.
On 9/18/2020 at 1956 surveillance footage revealed Staff I opened the patient's door, grabbed the patient by his right arm and threw the patient on the bed. Staff I was observed as he saddled the patient and tried to place him in a physical hold. Security Staff Q was observed as he rushed into the room and straddled the patient on the bed. A struggle ensued between the patient with security staff I and Q. The patient was observed as he was sliding off the bed while staff I and staff Q were on his chest. Staff R and S were observed attempting to hold the patient's feet. Staff Nurse O was observed as he entered the room and nudged Staff I to step away.
On 9/18/2020 at 1330 an interview was conducted with the Security Manager Staff H. Staff H was queried regarding training requirements for security staff I. Staff H replied, due to COVID-19 training has been on hold. When asked if Staff I had received training in Crisis Prevention Intervention (CPI) he replied, No we plan to resume training next month.
On 9/18/2020 at 1500, review of the personnel file for Security Staff I revealed his date of hire was 2/22/2020. There was no evidence in his file that documented Staff I was trained in CPI or PPCT.
Review of the Job description for the role of a Security Officer included the following:
"Responsibilities...Handle unruly customers from a variety of backgrounds and personalities with positive outcomes utilizing PPCT (Pressure Point Control Tactics) and CPI."