HospitalInspections.org

Based on review of facility policy, medical record review (MR), and staff interview (EMP), it was determined the facility failed to ensure frequent assessments for cardiac rhythms were completed in accordance with facility policy for four of four telemetry patient medical records reviewed (MR1, MR11, MR12, and MR13).

Findings include:

Review of facility policy, "Cardiac Monitoring on Medical Surgical Units and Stepdown Unit", dated February, 2019, revealed, "... Policy: ... 'Cardiac monitoring will be initiated and a rhythm strip will be placed in the medical record immediately upon admission to the unit, every eight hours at the beginning of the shift and with any rhythm change as indicated by patient's condition. ... "
Review of MR1 revealed a physician order for cardiac monitoring from May 31, 2019 and June 1, 2019. Further review of MR1 revealed no rhythm strips in the medical record for May 31, 2019 or June 1, 2019.
Review of MR11 revealed physician order for cardiac monitoring from May 1 to May 9, 2019. Further review of MR11 revealed rhythm strips on May 1, 2019 at 6 AM and 7 PM. No rhythm strips in MR1 for May 2, 2019, May 3 and May 4, 2019 rhythm strips at 6 AM and 6 PM, May 5, 2019 at 6 PM, May 6, 2019 at 6 AM and 2 PM, May 7, 2019 at 6 AM and 6 PM, May 8, and May 9, 2019 at 6AM.
Review of MR12 revealed physician order for cardiac monitoring from May 13 to May 15, 2019. Further review of MR12 revealed rhythm strips on May 13, 2019 at 10 PM, no rhythm strips on May 14, 2019 and rhythm strips on May 15, 2019 at 6 AM.
Review of MR13 revealed physician order for cardiac monitoring from May 13 to May 15, 2019. Further review of MR13 revealed rhythm strips on May 13 and 14, 2019, at 10 PM, and May 15 2019 at 6 AM and 10 PM.
Interview on July 22, 2019 at 11 AM confirmed the above findings.