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Tag No.: A0405
31007
Remains cited.
Based on medical record review, staff interview, and policy review the facility failed to ensure treatments and medications were administered per physician orders for two (Patient #15 and #17) of the 18 medical records reviewed. The hospital's census was 102.
Findings include:
1. Review of the medical record for Pt. #15 completed on 04/10/14 revealed an order for Albuterol Inhalation (Medication used to relax the muscles in the airway to increase airflow to the lungs) 4 times per day. The order was put in by the physician on 04/09/14 at 7:55 AM, released by the nurse at 9:30 AM, and the first does wasn't given by the respiratory therapist until 4:49 PM on 04/09/14. An order for a flutter valve (Used to help vibrate mucus away from airway walls and helps push mucus out of the airway) was noted for 4 times a day. The order was put in by the physician on 04/09/14 at 7:55 AM, released by the nurse at 9:30 AM, and the first treatment wasn't completed by the respiratory therapist until 8:10 AM on 04/10/14. No documentation was noted that the patient received the flutter valve and training before this time. This was confirmed by Staff G on 04/10/14 at approximately 2:15 PM.
2. Review of the medical record for Pt. #17 completed on 04/10/14 revealed an order for Albuterol + Ipratropium 2.5 mg-0.5 mg (Medication used to relax the muscles in the airway to increase airflow to the lungs) every 6 hours. The medication was given on 04/07/14 at 12:29 AM and not again until 8:10 AM over 7 hours later. It also given on 04/08/14 at 1:18 AM and not again until 9:07 AM over 7 hours later. This was confirmed by Staff G on 04/10/14 at 2:25 PM.
3. Review of the policy which had no policy number but was signed and approved on 03/24/14 and titled "General Medication Guidelines" was completed on 04/10/14. This policy revealed medications are considered on schedule if administered one hour before or after the prescribed time.
4. Review of the Respiratory Care Services Policy and Procedures, which had no policy number, name or signatures but was titled "Shift Responsibility Guidelines" was completed on 04/10/14. This policy revealed an order for every 6 hours are on the schedule 8:00 AM, 2:00 PM, 8:00 PM, and 2:00 AM. Administration of Pt #15 and #17 were over an hour out of these time frames.
5. Interview with Staff C completed on 04/10/14 at 2:30 PM revealed the reason the respiratory therapist are not meeting the shift responsibility guidelines time frames is because of not enough staff to give the medications/treatments at the specific times.
31597
Tag No.: A0700
03245
Based on staff interview, facility documentation, and staff confirmation, the facility failed to ensure the environment was maintained in a safe manner from fire in regards to fire and smoke damper testing. This could affect all 102 current patients in the facility.
Refer to A710.
This is a recite.
Tag No.: A0710
03245
Based on staff interview, facility documentation, and staff confirmation, it was verified the facility failed to meet the applicable provisions of the Life Safety Code of the National Fire Protection Association. The facility had a capacity of 302 beds with a census of 102 patients at the time of the post survey revisit completed on 04/10/14. Potentially all patients, visitors, and staff could be affected.
Findings include:
The facility failed to ensure that fire and smoke dampers complied with the provisions of NFPA 90A with regards to testing.
Refer to K67.
This is a recite.