HospitalInspections.org

Based on record review and staff interview it was determined the facility failed to ensure nursing staff followed their own expectation for nursing care in one (1) of ten (10) records reviewed for patients receiving nursing services (patient #1). Failure to ensure the availability of nursing care has the potential to negatively impact all patients.

Findings include:

1. Review of the medical record for patient #1 revealed she was admitted on 4/8/16 for a possible left hip fracture and pain. In a nurse's note dated 4/10/16, registered nurse (RN) #1 documented she was aware the patient's niece had asked to speak with her but was delayed in contacting the niece due to leaving the unit for a period of time.

2. In an interview with RN #1 on 4/26/16 at about 2:20 p.m., the above record was discussed. She stated when she first went to patient #1's room on 4/10/16 the niece had stepped out. She stated she knew the patient's niece wanted to talk to her but left the unit without notifying either the Charge Nurse or other team members of her departure to attend a unit meeting (which lasted at least ten (10) minutes) and then to an already scheduled appointment with employee health for her annual physical.

3. In an interview with the Clinical Manager on 4/26/16 at about 10:40 a.m. the above findings were discussed. She stated she was aware RN #1 left the unit without notifying the Charge Nurse or reporting to another RN. She stated her expectation is that RN #1 should have 'made a better decision' and reported to the Charge Nurse, or at least another staff nurse, that she was leaving the floor and her assigned patients.

Based on document review, observation and staff interview it was determined the hospital failed to develop and maintain the condition of the physical plant and overall hospital environment in such a manner that the safety and well being of the patients are assured.

Findings include:

1. A review of the "Housekeeping Required Daily Patient Room Cleaning" procedures revealed patient rooms are required to be cleaned daily, including bathrooms.

2. During an inspection of 5S on 4/25/16 at approximately 1:10 p.m., room 504 was observed to have a dirty air vent in the bathroom and the area at the base of the commode had a build up of what appeared to be dirt.

3. During an inspection of 5S on 4/25/16 at approximately 1:15 p.m., room 511 was observed to have a dirty air vent in the bathroom, the area at the base of the commode had a build up of what appeared to be dirt, the cove base was dirty and the corners had a build up of dirt. The patient room next to the corridor doors had a build up of dirt in the corners.

4. During an inspection of 5S on 4/25/16 at approximately 1:20 p.m., room 512 was observed to have a build up of dirt in the corners of the bathroom. There was a build up of dirt behind the commode. The patient room had a dirty cove base and holes in the patient room wall next to the corridor door.

5. During an inspection of 5S on 4/25/16 at approximately 1:25 p.m., room 502 was observed to have duct tape over the threshold.

6. An interview with the Director of Housekeeping on 4/26/16 confirmed the above noted patient rooms were required to be cleaned daily and he stated the hospital was addressing these issues in order to meet the requirement.