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DALLAS REGIONAL MEDICAL CENTER
STAFFING AND DELIVERY OF CARE
Tag No.: A0392
Based on record review and interview, the facility failed to ensure (adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed) compliance with the emergency room staffing plan for 4 designated technicians per shift (2 for acute and 2 for fast track/triage), in that,
16 of 32 shifts (11/15/2020 AM/PM, 11/14/2020 AM, 11/13/2020 AM, 11/12/20202 AM, 11/11/2020 AM/PM, 11/09/2020 AM/PM, 11/08/2020 PM, 11/06/2020 AM/PM, 11/05/2020 PM, 11/04/2020 PM, 11/03/2020 AM, 11/01/2020 AM) did not have the required four (4) designated technicians.
Findings included
The "Charge Nurse Assignment Sheet" reflected 11/15/2020 AM/PM, 11/14/2020 AM, 11/13/2020 AM, 11/12/20202 AM, 11/11/2020 AM/PM, 11/09/2020 AM/PM, 11/08/2020 PM, 11/06/2020 AM/PM, 11/05/2020 PM, 11/04/2020 PM, 11/03/2020 AM, 11/01/2020 AM did not have 4 designated technicians.
The 1/27/2020 signed "2019 Nurse Staffing Plan Evaluation" required, "Dallas Regional Emergency Department...Paramedics/EMT's (technicians) 2 in acute side and 2 in fast/triage..."
During an interview on 11/17/2020 ending at 5:08 PM, Personnel #3 was asked if they worked short staffed often. Personnel #3 stated, "Yes."
During an interview on 11/17/2020 ending at 5:45 PM, Personnel #4 was asked about the schedule having 1 or no technicians schedule on many shifts. Personnel #4 stated, "We work with what they give us. Would be nice to have another hand, but we just pitch in."
During an interview on 11/18/2020 ending at 2:51 PM, Personnel #5 was asked about no technicians scheduled and how busy the emergency room is. Personnel #5 stated, "It is difficult. We have a lot of ambulances and right now we have a lot of respiratory. A lot of shifts we are doing CPR on multiple patients and intubating more."
During an interview on 11/18/2020 ending at 4:09 PM, Personnel #2 was informed about the amount of technicians for the staffing plan versus the lack of scheduled technicians. Personnel #2 confirmed and stated, "Yes."