HospitalInspections.org

Based on review of medical records, review of hospital policy/procedure, and staff interview, it was determined that the nursing staff failed to ensure that the patient received care in a safe setting. The first dose of IV antibiotic was administered to the patient before the STAT order for blood cultures was collected.
.
Findings included:
.
In a review of patient #2 medical record, revealed patient #2 received the first dose of Ceftriaxone (Intravenous Antibiotic) before the venous blood specimen was collected for STAT Blood Cultures. Administering IV antibiotic prior to collecting the specimen for blood cultures may reduce the chances of getting a positive blood culture.
.
07/10/19 09:35 AM STAT order for Blood Culture.
07/10/19 10:00 AM Physician's Order -Ceftriaxone 1000 mg. IV Piggyback, q 24 hr., Initial dose administered7/10/19 at 10:26:00 AM
07/10/19 12:03 PM STAT Venous Blood for blood culture was collected.
07/11/19 10:39 Ceftriaxone 1000 mg. IV Piggyback (2nd dose) was administered.
07/11/19 to 7/15/19 1st through 5th day blood culture results -No Growth.
.
The above finding was confirmed by Staff #2 the morning of 09/11/19.

Based on review of medical records, review of hospital policy/procedure, and staff interview, it was determined that the facility failed to ensure that a "STAT" doctor's order for laboratory test were collected on a timely basis as per hospital policy.
.
Findings included:
.
Facility Policy titled, "Test Turn-Around-Time" states in part, "Principle: The laboratory has defined turnaround times (i.e., the interval between specimen receipt by laboratory personnel and results reporting) for each of its tests, and it has a policy for notifying the requester when testing is delayed.
B. STAT:
" STAT laboratory tests and services are those that are needed immediately in order to manage medical emergencies. STAT test requests are given high priority by the Clinical Laboratory for processing, analysis and reporting. If less urgent tests are also ordered STAT, a backlog may develop and each specimen will be processed in order of receipt, thereby delaying the reports for true emergencies.
" Our Goal: To be collected within fifteen minutes of time requested and laboratory alerted by phone. The results will be entered into the computer within one hour or receipt in the laboratory."

In a review of patient #2 medical record revealed the facility did not follow their policy. A STAT laboratory order for Blood Culture was collected 2 (two) hours and 28 minutes after it was ordered by the physician.

07/10/19 09:35 AM STAT order for Blood Culture.
07/10/19 10:00 AM Physician's Order -Ceftriaxone 1000 mg. IV Piggyback, q 24 hr., Initial dose administered7/10/19 at 10:26:00 AM
07/10/19 12:03 PM STAT Venous Blood for blood culture was collected.
07/11/19 10:39 Ceftriaxone 1000 mg. IV Piggyback (2nd dose) was administered.
07/11/19 to 7/15/19 1st through 5th day blood culture results -No Growth.

The above finding was confirmed with Staff # 2, Staff #2 confirmed the findings with the Laboratory staff and reported that Laboratory manager stated they were short staffed.