HospitalInspections.org

The Hospital reported a census of 48 patients. Based on record review, policy review and staff interview the Hospital failed to ensure physician orders were signed, dated and/or timed for 4 of 31 patient records reviewed (pt #'s 1,10,14 and 28).

Findings include:

- Patient #10's medical record reviewed on 6/19/12 revealed an admission date of 3/2/12 with diagnosis of Respiratory syncytial virus (a cold like virus). The hospital failed to ensure all verbal orders between the dates of 3/2/12-3/4/12 include date and time when authenticated by the physician.

- Patient #14's medical record reviewed on 6/19/12 revealed an admission date of 5/29/12 with diagnosis of stroke and atrial fibrillation (irregular heart rhythm). The hospital failed to ensure all verbal orders between the dates of 5/29/12-5/30/12 include date and time when authenticated by the physician.

The hospital policy "Medical Staff Rules and Regulations" directed medical staff " the phone, verbal or FAX order shall be authenticated by the prescribing or covering practitioner within 72 hours ... ". The Medical Staff Rules and Regulations fail to address the requirement to time all entries in the clinical record as well as date.

Staff F interviewed on 6/19/12 at 3:00pm revealed knowledge of the requirement to date and time all entries in the clinical record. Staff F acknowledged the hospital failed to ensure medical staff dated and timed all entries in the medical record. The hospital did not ensure the date and timing of verbal orders when authenticated by the physician.


This deficient practice also affected patient's #'s 1 and 28.

The Hospital reported a census of 48 patients. Based on observation, staff interview, and directions for use of cleaning the hospital failed to ensure staff followed acceptable standards for one of one cleaning of a discharged patient room. The hospital failed to assure patient care surfaces are maintained to be cleanable for four of six patient room beds.


Findings include:

- Directions for use of the cleaning solution Oasis 499 HBV Disinfectant states "...treated surfaces must remain wet for 10 minutes".

- Directions for use of the cleaning solution 65 Disinfecting Heavy Duty Acid Bathroom Cleaner states " Allow a 10-minute contact with the surface. Wipe with damp cloth or sponge. Rinse surface ".

- Observation of terminal cleaning of patient room on 6/18/12 from 1:40pm to 2:17pm of the Hospital revealed the following:

- Observation of Staff E on 6/18/12 at 1:40pm revealed the patient room and its contents wiped with a wet cloth containing Oasis 499 HBV Disinfectant prepared cleaning solution. A clock in the patient room revealed the solution on the surfaces evaporated in less than 10 minutes.

- Staff E interviewed on 6/18/12 at 1:30pm acknowledged Oasis HBV disinfectant cleaning solution is to stay wet on surfaces for a total of 10 minutes to work properly.

Staff C interviewed on 6/18/12 at 1:40pm acknowledged Oasis 499 HBV Disinfectant cleaning solution is to stay wet on surfaces for a total of 10 minutes to work properly.

- Staff E, observed on 6/18/12 at 2:02pm, revealed the patient bathroom and its contents sprayed with 65 Disinfecting Heavy Duty Acid Bathroom Cleaner. A clock in the patient room revealed solution on the surfaces was rinsed in 2 minutes.

- Staff E, interviewed on 6/18/12 at 2:00pm, acknowledged they did not know how long 65 Disinfecting Heavy Duty Acid Bathroom Cleaner should remain on the bathroom surfaces.

Staff C, interviewed on 6/18/12 at 2:07pm, acknowledged 65 Disinfecting Heavy Duty Acid Bathroom Cleaner should remain on the surface for 10 minutes.

The Hospital failed to assure the proper use of chemicals for the disinfecting of patient care surfaces.


- The hospital's policy titled "MRHC Departmental Cleaning Protocols", "General Equipment/Supply Issues", reviewed on 6/19/12 at 2:30pm, revealed covers on mattresses "...if the covering is ripped or torn, the item should be removed from service".

- Administrative staff A, interviewed on 6/18/12 at 3:30pm, acknowledged patient care surfaces are to be cleanable. Staff A confirmed any staff member that identifies a problem with equipment is to report the concern to a supervisor or maintenance.


- Staff C, interviewed on 6/18/12 at 3:30pm, confirmed patient care surfaces are to be cleanable.

- Patient room #327, observed on 6/18/12 at 3:30pm, revealed cracks and chips in the mattress covering, rendering the surface non-cleanable.

- Patient room #328, observed on 6/18/12 at 3:32pm, revealed cracks and chips in the mattress covering, rendering the surface non-cleanable.

- Patient room #329, observed on 6/18/12 at 3:30pm, revealed cracks, chips in the mattress covering, and a torn seam with foam exposed rendering the surface non-cleanable.

The practice of failing to identify the non-cleanable mattresses also affected the patient beds in rooms #331 and #342.