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CHILDREN'S HOSPITAL OF PHILADELPHIA
PATIENT RIGHTS: CARE IN SAFE SETTING
Tag No.: A0144
Based on a review of policy, facility documentation, medical record (MR) and interview with staff (EMP), it was determined the facility failed to ensure good quality care and high professional standards was provided to one of one patient. (MR1)
Findings include:
A review on October 15, 2014, of the facility "Patient and Family Bill of Rights and Responsibilities" effective date 2004 revealed, "You have the right to high quality care and high professional standards that are continually maintained and reviewed. ... ."
A review on October 15, 2014, of MR1 revealed an order written August 2, 2014, at 2:30 AM for "Nutramigen po ad lib 20 cal full str. no additives" and discontinued at 8:06 AM the same day. Further review of the MR1 revealed nursing documentation that the baby had received 30 ml at 2:56 AM and 135 ml of the prescribed formula at 8:00 AM.
Interviews conducted on October 15, 2014, at 2:00 PM with EMP2 and EMP8 confirmed that on August 2, 2014, the baby had ingested two (2) ounce bottles of the Nutramigen with use by dates of April 1, 2014.