Bringing transparency to federal inspections
Tag No.: A0776
Based on document review and interview it was revealed the hospital failed to ensure one (1) of forty-nine (49) (Registered Nurse) employees on the Mother Baby Unit followed hospital policy and procedure for self-monitoring and self-reporting COVID-19 symptoms before reporting to work. This failure has the potential to adversely affect all patients and staff.
Findings include:
1. A review of the facility policy entitled 'Highly Infectious Disease Preparedness Plan,' last revision date 9/20, revealed in part: "COVID-19 Staff (includes Licensed Independent Practitioners) Screening: a. All staff completes the COVID-19 Self Screening Attestation during orientation. b. Staff completes the self-screen upon entry into any Mountain Health Network facility. c. If the answer is "yes" to any of the screening questions then the staff member will exit the facility and not return until medically cleared. The medical evaluation process will include an active temperature assessment ..."
2. A review of the facility document entitled 'Employee Entrance COVID-19 Screening Attestation Form' revealed in part: "By signing this form, I acknowledge that I understand that I have a continuing obligation to self-screen on a daily basis and to self-quarantine if any of my answers to the screening questions listed below are "YES" and to inform my supervisor and Occupational Health/Employee Health. I further acknowledge that this is for my health and safety as well as the health and safety of my patients and co-workers. Have you experienced any of the following symptoms in the past 48 hours: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste of smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea ...?"
3. A review of the facility document entitled 'Student and Group Transcript Report' generated on 8/30/21 revealed the Registered Nurse (RN) had signed the 'COVID-19 Self Screening MHN Attestation' on 5/14/20.
4. A review of the facility document entitled 'Daily Patient Assignment Record - Mother Baby Unit' dated 8/13/21 revealed the RN had worked from 7 p.m. to 7 a.m.
5. A review of the facility document entitled 'Daily Patient Assignment Record - Mother Baby Unit' dated 8/14/21 revealed the RN had worked from 7 p.m. to 7 a.m.
6. A review of the facility document entitled 'Employee COVID Screening' dated 8/18/21 revealed in part: "The RN had notified the Occupational Health Department on 8/18/21 at 9:07 a.m. of COVID symptoms including "8/13 - didn't feel well but not real bad-runny nose" and COVID test completed on 8/17/21, Result: Positive."
7. An interview conducted with the Nurse Manager of the Mother Baby Unit on 8/30/21 at approximately 2:30 p.m. revealed the RN had been on vacation August 6th to August 11th and returned to work on August 12th. he/she worked on August 12th, 13th and 14th and was off on August 15. he/she did not report any symptoms on the days he/she had worked. On August 16 she was on call. They had called her at 3 p.m. to tell her he/she would be needed on night shift. he/she called them back at 6 p.m. and said he/she had just eaten for the first time that day and had lost he/her sense of taste and smell. He/she was told to not come to work and to go to the testing tent the next morning to be tested for COVID-19. During their investigation it was revealed the RN had felt tired and had a runny nose and had associated it with the time change from traveling.
8. A telephone interview conducted with the RN on 8/31/21 at approximately 9:05 a.m. revealed he/she had been on vacation from Friday, August 6th to Wednesday August 11th. he/she had vacationed in Montana, traveling by airplane, and went hiking in the Glacier National Forest. He/she returned to work on August 12th. he/she stated he/she started to "feel bad" on Friday and Saturday - August 13th and August 14th. he/she stated /heshe "didn't feel well, had slight runny nose" and "thought it was from hiking."
9. An interview was conducted with the Director of Quality and Patient Safety on 8/31/21 at 2:40 p.m. and he/she agreed the RN had not followed the policy for self-monitoring and self-reporting as agreed to in the attestation statement.